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BMJ Case Rep ; 20182018 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-29622716

RESUMEN

An 8-year-old boy presented to our hospital with complaints of fever, epigastric pain and headache. Enterococcus faecalis were isolated from urine and blood culture, bacteraemic urinary tract infection was clinically diagnosed. Although vancomycin and ampicillin were administrated, fever did not subside. Contrast-enhanced CT (CECT) revealed bilateral and multiple wedge-shaped defects, thus prompting a diagnosis of acute lobar nephronia (ALN). After 7 days of antibiotic treatment, the patient's fever subsided. ALN can be classified into two subgroups based on features of CECT; simple and complicated ALN. The treatment response to antibiotics tends to be delayed in complicated ALN, it is important that we understand the natural course of complicated ALN and should not escalate antibiotics hastily. According to previous studies, ALN has a wide regional variety of causative organisms. Therefore, the physician should recognise a local pattern of microbiological aetiology of ALN.


Asunto(s)
Enterococcus faecalis/aislamiento & purificación , Infecciones por Bacterias Grampositivas/diagnóstico , Pielonefritis/diagnóstico por imagen , Infecciones Urinarias/diagnóstico , Reflujo Vesicoureteral/diagnóstico por imagen , Dolor Abdominal , Enfermedad Aguda , Antibacterianos/uso terapéutico , Niño , Fiebre , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Cefalea , Humanos , Masculino , Pielonefritis/terapia , Derivación y Consulta , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Infecciones Urinarias/tratamiento farmacológico , Reflujo Vesicoureteral/terapia
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