Bibalo C, Apicella A, Guastalla V, Marzuillo P, Zennaro F, Tringali C, Taddio A, Germani C, Barbi E. Acute lobar nephritis in children: Not so easy to recognize and manage. World J Clin Pediatr 2016; 5(1): 136-142 [PMID: 26862513 DOI: 10.5409/wjcp.v5.i1.136]
Corresponding Author of This Article
Pierluigi Marzuillo, MD, Department of Women and Children and General and Specialized Surgery, Seconda Università degli Studi di Napoli, Via L. De Crecchio n° 2, 80138 Naples, Italy. pierluigi.marzuillo@gmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Feb 8, 2016; 5(1): 136-142 Published online Feb 8, 2016. doi: 10.5409/wjcp.v5.i1.136
Acute lobar nephritis in children: Not so easy to recognize and manage
Cristina Bibalo, Andrea Apicella, Veronica Guastalla, Pierluigi Marzuillo, Floriana Zennaro, Carmela Tringali, Andrea Taddio, Claudio Germani, Egidio Barbi
Cristina Bibalo, Veronica Guastalla, Andrea Taddio, Department of Pediatrics, University of Trieste, 34100 Trieste, Italy
Andrea Apicella, Pierluigi Marzuillo, Department of Women and Children and General and Specialized Surgery, Seconda Università degli Studi di Napoli, 80138 Naples, Italy
Floriana Zennaro, Andrea Taddio, Claudio Germani, Egidio Barbi, Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, 34100 Trieste, Italy
Carmela Tringali, Pediatric Ward, Ospedale di San Daniele, San Daniele del Friuli, 33038 Udine, Italy
Author contributions: Bibalo C, Apicella A and Guastalla V wrote the manuscript; Marzuillo P and Zennaro F supervised the manuscript drafting; Tringali C and Germani C critically revised and contributed to conceptually improve the manuscript; Taddio A and Barbi E conceived the manuscript.
Institutional review board statement: The study was reviewed and approved by the Seconda Università degli studi di Napoli Institutional Review Board.
Informed consent statement: All study partecipants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pierluigi Marzuillo, MD, Department of Women and Children and General and Specialized Surgery, Seconda Università degli Studi di Napoli, Via L. De Crecchio n° 2, 80138 Naples, Italy. pierluigi.marzuillo@gmail.com
Telephone: +39-081-5665465 Fax: +39-081-5665435
Received: August 19, 2015 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
Abstract
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.
