Multiple Renal Abscess by Extended-Spectrum beta-Lactamase Producing Escherichia coli / 대한신장학회잡지

ABSTRACT

Extended-spectrum beta-lactamase (ESBL) producing bacterial infection causes delayed response to antibiotic treatment and consequently results in serious problem, because it can hydrolyze the majority of beta-lactam antibiotics. Here we report a case of multiple renal abscess by ESBL producing Escherichia coli in a patient with diabetes mellitus who had a history of repetitive urinary tract infection. A 49-year old woman was admitted to our hospital because of intermittent fever, left flank pain, and vomiting. She had been diagnosed as acute pyelonephritis and treated with the first and third cephalosporin for 1 month at a clinic. At admission, urinary bacterial culture revealed Escherichia coli resistant to both the first and third cephalosporin such as cefotaxime, ceftriaxone, and ceftazidime. Double disk synergy test confirmed ESBL. Abdominal computed tomography demonstrated multiple renal abscess. After treatment of imipenam for 4 weeks, she discharged with improved condition.