{"title":"47日龄男婴黄色肉芽肿性肾盂肾炎1例报告。","authors":"Yeping Jiang, Menglin Chang, Qian Fu, Hui Wang","doi":"10.3389/fped.2025.1625781","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Xanthogranulomatous pyelonephritis (XGP), a rare granulomatous renal disease linked to bacterial infection (e.g., <i>Escherichia coli</i>), presents challenges in pediatric diagnosis, especially in infants, due to overlap with neoplastic renal masses like Wilms tumor.</p><p><strong>Case summary: </strong>A 47-day-old male infant with fever, elevated inflammatory markers (WBC 13.94 × 10<sup>9</sup>/L, CRP 110.43 mg/L), and urinary leukocytes/hematuria showed a left renal mass (1.7 × 1.8 × 2.1 cm) on imaging. Biopsy revealed histiocytic-neutrophilic infiltration with focal necrosis, and metagenomic sequencing identified dominant E. coli. Antibiotic therapy (cefoperazone-sulbactam followed by cefdinir) induced regression (1.1 × 0.8 × 1.1 cm at 2 weeks). Elevated AFP (888.27 ng/ml) normalized, excluding malignancy.</p><p><strong>Conclusion: </strong>This case highlights XGP as a critical differential diagnosis for febrile infants with renal masses. Integration of histopathology, metagenomic sequencing, and prolonged follow-up confirms that focal XGP can be managed successfully with targeted antibiotics, avoiding nephrectomy.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1625781"},"PeriodicalIF":2.1000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286814/pdf/","citationCount":"0","resultStr":"{\"title\":\"Xanthogranulomatous pyelonephritis in a 47-day-old male infant: a case report.\",\"authors\":\"Yeping Jiang, Menglin Chang, Qian Fu, Hui Wang\",\"doi\":\"10.3389/fped.2025.1625781\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Xanthogranulomatous pyelonephritis (XGP), a rare granulomatous renal disease linked to bacterial infection (e.g., <i>Escherichia coli</i>), presents challenges in pediatric diagnosis, especially in infants, due to overlap with neoplastic renal masses like Wilms tumor.</p><p><strong>Case summary: </strong>A 47-day-old male infant with fever, elevated inflammatory markers (WBC 13.94 × 10<sup>9</sup>/L, CRP 110.43 mg/L), and urinary leukocytes/hematuria showed a left renal mass (1.7 × 1.8 × 2.1 cm) on imaging. Biopsy revealed histiocytic-neutrophilic infiltration with focal necrosis, and metagenomic sequencing identified dominant E. coli. Antibiotic therapy (cefoperazone-sulbactam followed by cefdinir) induced regression (1.1 × 0.8 × 1.1 cm at 2 weeks). Elevated AFP (888.27 ng/ml) normalized, excluding malignancy.</p><p><strong>Conclusion: </strong>This case highlights XGP as a critical differential diagnosis for febrile infants with renal masses. Integration of histopathology, metagenomic sequencing, and prolonged follow-up confirms that focal XGP can be managed successfully with targeted antibiotics, avoiding nephrectomy.</p>\",\"PeriodicalId\":12637,\"journal\":{\"name\":\"Frontiers in Pediatrics\",\"volume\":\"13 \",\"pages\":\"1625781\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-07-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286814/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fped.2025.1625781\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2025.1625781","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Xanthogranulomatous pyelonephritis in a 47-day-old male infant: a case report.
Background: Xanthogranulomatous pyelonephritis (XGP), a rare granulomatous renal disease linked to bacterial infection (e.g., Escherichia coli), presents challenges in pediatric diagnosis, especially in infants, due to overlap with neoplastic renal masses like Wilms tumor.
Case summary: A 47-day-old male infant with fever, elevated inflammatory markers (WBC 13.94 × 109/L, CRP 110.43 mg/L), and urinary leukocytes/hematuria showed a left renal mass (1.7 × 1.8 × 2.1 cm) on imaging. Biopsy revealed histiocytic-neutrophilic infiltration with focal necrosis, and metagenomic sequencing identified dominant E. coli. Antibiotic therapy (cefoperazone-sulbactam followed by cefdinir) induced regression (1.1 × 0.8 × 1.1 cm at 2 weeks). Elevated AFP (888.27 ng/ml) normalized, excluding malignancy.
Conclusion: This case highlights XGP as a critical differential diagnosis for febrile infants with renal masses. Integration of histopathology, metagenomic sequencing, and prolonged follow-up confirms that focal XGP can be managed successfully with targeted antibiotics, avoiding nephrectomy.
期刊介绍：
Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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