A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae
Pyonephrosis is a rare condition in both adult and pediatric population. Here, the author presents a rare case of pyonephrosis induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a 12-month-old girl presenting with a picture of urosepsis. The patient presented with febrile...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Saudi Journal of Medicine and Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sjmms.net/article.asp?issn=1658-631X;year=2020;volume=8;issue=2;spage=156;epage=159;aulast=Alsowayan |
| _version_ | 1818476432782786560 |
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| author | Ossamah Saleh Alsowayan |
| author_facet | Ossamah Saleh Alsowayan |
| author_sort | Ossamah Saleh Alsowayan |
| collection | DOAJ |
| description | Pyonephrosis is a rare condition in both adult and pediatric population. Here, the author presents a rare case of pyonephrosis induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a 12-month-old girl presenting with a picture of urosepsis. The patient presented with febrile urinary tract infection and was unresponsive to intravenous meropenem. Physical examination revealed huge, firm and irregular right renal swelling. Ultrasound and computed tomography imaging revealed severely hydronephrotic right kidney, and laboratory investigations showed elevated C-reactive protein level (22.9 mg/dl). Emergency percutaneous nephrostomy tube was inserted, pus was drained (20 ml) and intravenous vancomycin and amikacin were started. Her general condition improved, and urine culture was negative. Functional assessment with dimercaptosuccinic acid renal scan revealed that the split renal function was 5% on the right and 95% on the left side, and the bladder outline was smooth with no reflux in voiding cystourethrogram. A right nephrectomy was done a week later using the anterior subcostal approach. The postoperative course was smooth. Histopathological examination was diagnostic for xanthogranulomatous pyelonephritis. No adverse events were reported in the follow-up over 12 months. It can be concluded that a high degree of suspicion, rapid initiation of appropriate antibiotics and drainage of pus are crucial in the management of pyonephrosis. |
| first_indexed | 2024-12-10T09:25:34Z |
| format | Article |
| id | doaj.art-536d25094c964f8a907a945baa030221 |
| institution | Directory Open Access Journal |
| issn | 1658-631X |
| language | English |
| last_indexed | 2024-12-10T09:25:34Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Medicine and Medical Sciences |
| spelling | doaj.art-536d25094c964f8a907a945baa0302212022-12-22T01:54:33ZengWolters Kluwer Medknow PublicationsSaudi Journal of Medicine and Medical Sciences1658-631X2020-01-018215615910.4103/sjmms.sjmms_91_18A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniaeOssamah Saleh AlsowayanPyonephrosis is a rare condition in both adult and pediatric population. Here, the author presents a rare case of pyonephrosis induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a 12-month-old girl presenting with a picture of urosepsis. The patient presented with febrile urinary tract infection and was unresponsive to intravenous meropenem. Physical examination revealed huge, firm and irregular right renal swelling. Ultrasound and computed tomography imaging revealed severely hydronephrotic right kidney, and laboratory investigations showed elevated C-reactive protein level (22.9 mg/dl). Emergency percutaneous nephrostomy tube was inserted, pus was drained (20 ml) and intravenous vancomycin and amikacin were started. Her general condition improved, and urine culture was negative. Functional assessment with dimercaptosuccinic acid renal scan revealed that the split renal function was 5% on the right and 95% on the left side, and the bladder outline was smooth with no reflux in voiding cystourethrogram. A right nephrectomy was done a week later using the anterior subcostal approach. The postoperative course was smooth. Histopathological examination was diagnostic for xanthogranulomatous pyelonephritis. No adverse events were reported in the follow-up over 12 months. It can be concluded that a high degree of suspicion, rapid initiation of appropriate antibiotics and drainage of pus are crucial in the management of pyonephrosis.http://www.sjmms.net/article.asp?issn=1658-631X;year=2020;volume=8;issue=2;spage=156;epage=159;aulast=Alsowayanextended-spectrum beta-lactamaseinfantinfectionpyonephrosissepsis |
| spellingShingle | Ossamah Saleh Alsowayan A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae Saudi Journal of Medicine and Medical Sciences extended-spectrum beta-lactamase infant infection pyonephrosis sepsis |
| title | A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae |
| title_full | A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae |
| title_fullStr | A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae |
| title_full_unstemmed | A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae |
| title_short | A rare case of pyonephrosis in an infant induced by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae |
| title_sort | rare case of pyonephrosis in an infant induced by extended spectrum beta lactamase producing klebsiella pneumoniae |
| topic | extended-spectrum beta-lactamase infant infection pyonephrosis sepsis |
| url | http://www.sjmms.net/article.asp?issn=1658-631X;year=2020;volume=8;issue=2;spage=156;epage=159;aulast=Alsowayan |
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