Search

Contrast-enhanced CT is the gold standard for the diagnosis of acute focal bacterial nephritis (AFBN). However, owing to radiation exposure and the possibility of contrast agent-induced side effects, contrast-enhanced CT is not always recommended for children. A paediatric patient presenting with a 1-week history of fever was admitted to our hospital. After a urine culture detected Escherichia coli, antimicrobials were administered; however, the fever had not resolved by the third day of hospitalisation. Renal diffusion-weighted MRI was performed and showed multiple wedge-shaped areas of high signal intensity in the right kidney. Additionally, the same site showed an area of low signal intensity in the apparent diffusion coefficient, and a diagnosis of AFBN with abscess was made. A chronic-phase technetium99m-labelled dimercaptosuccinic acid renal scintigraphy was performed, but there was no renal scarring. MRI may be a more suitable tool for diagnosing AFBN given no radiation exposure. [ABSTRACT FROM AUTHOR]

Severe atopic dermatitis (AD) may lead to various complications such as hypoproteinaemia. We describe the case of a 7-month-old male infant with severe AD complicated with protein-losing enteropathy (PLE). He was diagnosed with AD at 2 months of age; however, because of familial steroid phobia, topical corticosteroids were not administered. At 7 months of age, he was admitted to our hospital for decreased feeding, diarrhoea, reduced urine volume and recurrent vomiting. Class 3 topical corticosteroid treatment was initiated. On day 3, eczema had almost resolved. However, serum protein levels had not improved; oliguria persisted and oedema worsened. Serum albumin scintigraphy revealed radioisotopes in the distal duodenum, leading to PLE diagnosis. Systemic prednisolone and albumin were administered, with no PLE relapse after discontinuation. To our knowledge, only two infant PLE cases associated with AD were reported to date. PLE should be considered in patients with severe AD and persistent hypoproteinaemia. [ABSTRACT FROM AUTHOR]