Acute focal bacterial nephritis: a case series
Acute focal bacterial nephritis (AFBN) is a bacterial infection of the renal parenchyma without abscess formation and is classified as a subtype of acute renal pyelitis.

There are many reports of AFBN in pediatrics; however, urinary tract infection, cystitis, or pyelitis developed into AFBN in few adult cases. AFBN symptoms include fever, shivering, back pain, and/or costovertebral angle tenderness.

Published in the World Journal of Nephrology and Urology, the authors report two adult cases of AFBN in which its diagnosis using contrast-enhanced computed tomography was helpful.

Case 1
A 41-year-old female visited a home clinic complaining of high grade fever (38.5 °C) and a severe headache which lasted for a couple of days. Meningitis was suspected from her medical consultation and physical examination. Following that, she was referred to our emergency department for further examination. Her past medical history included diabetes milieus type II, which was treated using oral drugs.

Then contrast-enhanced CT was performed on the day of admission, revealing wedge-shaped, non-contrast, and low density mass-like lesions in the right kidney consistent with AFBN. Consequently, anti-bacterial agents were initiated. After 3 weeks of antibacterial treatment, chemical analyses of inflammatory response dramatically improved, and symptoms completely disappeared.

Case 2
A 78-year-old female presented with complaints of fatigue, headache, and low grade fever lasting for a couple of days. Her medical history included hypertension, which was treated using medicine. She had no history of urinary tract infection.

Contrast CT revealed wedge-shaped defects as well as enhancement in the right kidney which suggests that infection has been present for some time. She was then diagnosed with AFBN and antibacterial treatment was initiated. After 3 weeks of antibacterial treatment, chemical analyses and her symptoms improved.

Read in detail about the cases here:
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