Acute lobar nephritis in children: Not so easy to recognize and manage

Table 1 Clinical and laboratoristic acute lobar nephritis differential diagnosis

	Clinical and laboratoristic ALN differential diagnosis
APN	Leukocyturia and bacteriuria
Appendicitis[26]	Mc Burney, Blumberg and Rovsing’s sign, right iliac fossa pain, typical age
Gastroenteritis[27]	Diarrhea, dehydration’s signs
Infected urachal cyst[28]	Belly button discharge
Nephrolithiasis[29]	Colic pain, familiarity, previous episode, micro/macrohematuria, Giordano’s sign
Pancreatitis[30]	Typical pain, serum amylase and lipase elevated
Pelvic inflammatory disease[31]	Sexually active female, irregular periods, vaginal discharge, dyspareunia, lower abdomen pain
Pneumonia[32]	Dyspnea, cough, typical auscultation, Sat O2 < 96%
Sickle cell disease[33]	Anemia, decreased haptoglobin, sickle cell, ethnicity

Differential diagnosis with other conditions such as abdominal abscess, infected intestinal duplication and nephrolithiasis need radiological evaluation. ALN: Acute lobar nephritis; APN: Acute pyelonephritis.