Acute focal bacterial nephritis with vesicoureteral reflux in infants

Background Acute focal bacterial nephritis (AFBN) is a seldom infection in children kidney disease,Vesicoureteral reflux(VUR) often exist in infants who are easy to have urinary tract infection(UTI).In this study,we summarize the clinical features ,imaging and therapy. Methods eleven patients with AFBN and VUR aged from two months to eight months treated at this hospital from January 2017 to August 2019 were reviewed.The manifestations,urine and blood tests, imagings,treatments of patients were analyzed retrospectively. Results Fever was the common symptom,blood CRP was higher than normal(25 mg/L-200 mg/L),The percentage of neutrophils in blood was 52%-85%.The ratio of neutrophils to lymphocytes was 1.39–11.6,Routine urine microscopic examination of leukocyte was +∽3+/HP,Urine culture samples were 42, 34 samples were positive, the positive rate was 80.95%.Diagnosis was set by CT combined MCU.Enhanced CT conducted for all patients showed hypoperfused wedged-shaped or round and space-occupying lesions in kidney.MCU conducted showed I-V grade VUR in single or both sides.9 cases were treated with prophylactic antibiotics, DxHA injection was operated on 1 case, cohen operation for another patient.Relapses were rarely occur after insisting on treatment. Conclusion AFBN in children are rare and associated with VUR. Patients with AFBN should perform MCU to find out VUR and insist on prophylactic antibiotic until the VUR disappeared, patients with recurrent infection and serious VUR need urological treatment in order to prevent the formation of renal scar.