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BMJ Case Rep ; 20182018 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-29622716

RESUMO

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.


Assuntos
Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas/diagnóstico , Pielonefrite/diagnóstico por imagem , Infecções Urinárias/diagnóstico , Refluxo Vesicoureteral/diagnóstico por imagem , Dor Abdominal , Doença Aguda , Antibacterianos/uso terapêutico , Criança , Febre , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Cefaleia , Humanos , Masculino , Pielonefrite/terapia , Encaminhamento e Consulta , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Infecções Urinárias/tratamento farmacológico , Refluxo Vesicoureteral/terapia
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