Published online Feb 8, 2016. doi: 10.5409/wjcp.v5.i1.136
Peer-review started: August 22, 2015
First decision: October 13, 2015
Revised: November 17, 2015
Accepted: December 17, 2015
Article in press: December 18, 2015
Published online: February 8, 2016
Processing time: 161 Days and 15.4 Hours
Acute lobar nephritis (ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.
Core tip: Acute lobar nephritis (ALN) is a renal bacterial infection presenting difficult diagnosis due to the lack of specific symptoms and laboratory findings. Suspecting ALN in children with septic fever with or without clinical signs should be part of the diagnostic tool of clinicians. The diagnosis is relevant both to prefer intravenous antibiotic therapy and suggest an overall length of antibiotic treatment not shorter than 3 wk. We review the literature and analyze the ALN clinical presentation, with the aim to give to the clinician the elements to suspect, diagnose and accurately treat ALN in children.