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acute lobar nephronia in adults

Sean P Conley, Kenneth Frumkin
BACKGROUND: Patients with fever, vomiting, and abdominal pain commonly present to the emergency department, often generating a broad differential diagnosis. We describe the first reported case in the emergency medicine literature of acute lobar nephronia (ALN). OBJECTIVES: To describe the presentation, evaluation, and management of acute lobar nephronia. CASE REPORT: A healthy 27-year-old woman presented after 18 h of fever to 39.94°C (103...
May 2014: Journal of Emergency Medicine
Tanja Seidel, Eberhard Kuwertz-Bröking, Sigrid Kaczmarek, Martin Kirschstein, Michael Frosch, Monika Bulla, Erik Harms
Acute focal bacterial nephritis (AFBN), formerly known as lobar nephronia, is a rare form of interstitial bacterial nephritis. Most often described in adults with diabetes, there is only limited knowledge of AFBN in children. Ultrasound shows circular hypoechogenic, hypoperfused parenchyma lesions, which may be misdiagnosed as a renal abscess or tumor. From 1984 to 2005, AFBN was diagnosed in 30 children at the University Hospital Münster and the General Hospital Celle, Germany. Data of 25 cases (14 girls, 11 boys) were available for retrospective evaluation...
November 2007: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
N Joss, G Baxter, B Young, L Buist, R S C Rodger
We report a patient who presented with a solid mass in her graft 15 years after renal transplantation. The appearances by ultrasound were consistent with either malignancy or lobar nephronia (focal acute bacterial nephritis). Biopsy confirmed the diagnosis of a lobar nephronia with marked inflammatory infiltrate and frank pus formation. Treatment with antibiotics was associated with resolution of the mass. Lobar nephronia is a diagnosis based upon renal ultrasonography and must be considered in a patient with a solid mass in the kidney...
October 2005: Clinical Nephrology
Ahmed Ameur, Mohamed Lezrek, Hassan Boumdin, Amoqrane Beddouch
Focal bacterial nephritis or lobar nephronia represents an acute localized non-liquefactive infection of the kidney caused by bacterial infection. This is an uncommon form of pyelonephritis that can affect both adults and children. Imaging techniques, particularly CT scan, are necessary for diagnosis and to distinguish it from other conditions (abscess or renal masses) that require a different treatment. The authors describe a case of acute lobar nephronia in a 24-year-old man.
June 2002: Progrès en Urologie
M I Frieyro Seguí, M J Martín Aguado, A Canals Baeza, J Molla Nicova, J Camps Herrero, F Segarra Aznar
We present three patients, aged 4, 6 and 8 years old, with a diagnosis of urinary tract infection. In all patients, initial ultrasonographic studies revealed a single area of acute lobar nephronia (ALN). The patients underwent renal scintigraphy with dimercaptosuccinic acid-99mTc (DMSA Tc 99m), which showed multiple foci with below normal uptake in both kidneys of two patients, consistent with bilateral multifocal bacterial nephritis. Although this entity has been reported together with ALN in adults, very few pediatric cases have been reported...
September 2001: Anales Españoles de Pediatría
F J García-Penit, F Monreal García de Vicuña, A Collado Serra, L Gausa Gascón, M Montlleó
OBJECTIVE: To report a case of acute lobar nephronia, an unusual form of localized renal infection, and review the literature with special reference to the clinical features, ultrasound and CT findings that distinguish this condition from other renal masses (abscess, infected cyst and renal carcinoma). METHODS/RESULTS: A female patient presented at the emergency services with symptoms and signs compatible with pyelonephritis. An admission abdominal ultrasound scan demonstrated a solid mass in the left inferior renal pole...
January 2001: Archivos Españoles de Urología
P D Kumar, L A Brown
A focal infection of the kidney can cause a diagnostic dilemma by mimicking a neoplasm. We describe a case of focal bacterial nephritis (acute lobar nephronia) caused by Escherichia coli in which the diagnosis was confirmed only after surgical exploration. Although the patient had fever on admission, urine and blood cultures were negative and fine needle aspiration of the kidney could not rule out a well-differentiated carcinoma.
September 2000: American Journal of the Medical Sciences
V Rodrigo Guanter, A Serrano Durbá, C Domínguez Hinajeros, F García Ibarra
OBJECTIVE: A case of lobar nephronia in a child is presented. METHODS: Herein we describe a case of acute lobar nephronia in a 10-year-old boy. The clinical, diagnostic and therapeutic aspects are discussed. RESULTS/CONCLUSIONS: Acute lobar nephronia or acute focal bacterial nephritis is an uncommon form of pyelonephritis that can affect both adults and children, although few cases have been reported in children. Imaging techniques are necessary for diagnosis and to distinguish it from other conditions, such as abscess or renal masses that require a different treatment...
April 2000: Archivos Españoles de Urología
Y Li, Y Zhang
OBJECTIVE: Acute focal bacterial nephritis (AFBN) or acute lobar nephronia represents an acute localized non-liquefactive infection of the kidney caused by bacterial infection. The main manifestations consist of fever, chills, abdominal pain, flank pain, and tenderness and percussion pain of the costoverbral angles. Ultrasound and CT examinations identify the renal parenchymal space-occupying lesion which may resemble renal abscess or carcinoma. The clinical symptoms and the renal mass disappear following anti-infection treatment...
February 1996: Chinese Medical Journal
H D Fawcett, D A Goodwin, R L Lantieri
In-111-leukocyte scanning has recently been introduced as a clinically effective method for detecting inflammatory disease and abscesses. The authors present six cases that demonstrate the usefulness of this new technique in suspected inflammatory renal disease. Two patients had renal abscesses, two had acute pyelonephritis, one had acute focal bacterial nephritis (acute lobar nephronia), and one had a transitional cell carcinoma with associated acute and chronic inflammation.
June 1981: Clinical Nuclear Medicine
E N Rauschkolb, C M Sandler, S Patel, T L Childs
The value of computed tomography (CT) in patients with severe renal inflammatory disease has not been previously emphasized. This paper presents the authors' experience using this modality in 17 patients with acute intrarenal inflammatory conditions. A spectrum of various renal abnormalities and their CT appearance ranging from lobar nephronia (focal pyelonephritis) to xanthogranulomatous pyelonephritis is presented. These cases demonstrate that CT provides more precise anatomic information than does urography and is helpful in distinguishing uncomplicated patterns of renal infection from other types of renal inflammatory disease...
June 1982: Journal of Computer Assisted Tomography
R I McCoy, A B Kurtz, M D Rifkin, M B Kodroff, M M Bidula
A case of acute focal bacterial nephritis (lobar nephronia) which evolved into a renal abscess is reported. This case is unusual for 2 reasons: the focal nephritis was isoechoic (not previously reported), and it progressed to an abscess despite antibiotic therapy. Ultrasound initially detected the focal nephritis and later confirmed its progression to an abscess. Successful treatment was obtained with sonographically guided percutaneous catheter drainage in conjunction with systemic antibiotics.
1985: Urologic Radiology
M R Zaontz, J J Pahira, M Wolfman, A J Gargurevich, R K Zeman
Acute focal bacterial nephritis, synonymous with acute lobar nephronia or focal nonliquefactive pyelonephritis, represents a localized area of renal inflammation. Clinically, acute focal bacterial nephritis presents as acute pyelonephritis but is distinguishable by the presence of a focal mass on excretory urography. The further distinction between acute focal bacterial nephritis and other renal masses is aided by the appropriate use of renal sonography and computerized tomography. The clinical and imaging manifestations in 9 patients with acute focal bacterial nephritis are described...
May 1985: Journal of Urology
H Ehara, T Takeuchi, K Kobayashi, H Hayashi, Y Nagatani, M Kanematsu, M Kuriyama, Y Ban, Y Kawada, S Fujihiro
Acute focal bacterial nephritis (AFBN) is one of the acute renal infections, its entity can be distinguished from other renal infections by the findings of sonography and computed tomography. There is no evidence of liquefaction in focal masses of AFBN in contrast to renal abscess. We present two cases with AFBN. The first case was a 52-year-old man with diabetes mellitus and benign prostatic hypertrophy. The second case was a 24-year-old woman with bilateral vesico-ureteral refluxes. Although their initial symptoms mimicked those of acute pyelonephritis, the findings of sonography and computed tomography revealed renal masses...
January 1989: Nihon Hinyōkika Gakkai Zasshi. the Japanese Journal of Urology
A T Rosenfield, M G Glickman, K J Taylor, M Crade, J Hodson
Acute lobar nephronia (ALN) refers to a renal mass caused by acute focal infection without liquefaction. The radiological findings in 12 patients with 13 episodes of ALN are described. A characteristic combination of uroradiological findings is (a) a relatively sonolucent mass which disrupts corticomedullary definition on ultrasonography; (b) a solid-appearing mass on other uroradiological studies; and (c) a positive gallium image in the region of the mass, which may be associated with increased activity elsewhere in the same or opposite kidney...
September 1979: Radiology
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