Serial sonographic findings during progression from acute py
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Upper UTI is classified as acute pyelonephritis (APN), acute focal bacterial nephritis (AFBN) or renal abscesses. From the points of view of imaging studies, these diagnoses are defined as follows: APN appears normal kidney images without mass lesions whereas both AFBN and renal abscesses show mass lesions. The masses seen in AFBN do not present with liquefaction but those in renal abscesses have walled-off cavities with liquefaction. Renal abscesses, mostly believed to be progressive lesions from urologic infections such as APN and AFBN can occur secondary to hematogenous seeding; they are very rare and are often accidentally detected while examining for idiopathic fever when the abscesses are completed. Probably for these reasons, there are no reports that demonstrate the serial imaging changes associated with APN progressing to renal abscess. We experienced the case of a 6-month-old boy with hyper-immunoglobulin E syndrome (HIES), a rare primary immunodeficiency, who developed APN that progressed to renal abscess despite the fact that pathogenic bacteria of the first urine culture was susceptible to initial antibiotic therapy which was administered since the early stage of the disease. We describe here the serial sonographic findings of the patient...

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