Acute
lobar nephronia is an uncommon type of urinary tract infection which was first
described by Rosenfield in 1979 . Pathologically, it is a focal area of
infected kidney without tissue liquefaction. It is thought to represent a
disease state midway between tissue inflammation and abscess formation. On
radiological imaging, acute lobar nephronia can be mistaken for a neoplastic
condition if acute symptoms are not taken into account. Most of the published
case reports or series have focused mainly on the pediatric population. Only a
few cases have been reported in adults. Most cases of acute lobar nephronia are
associated with Escherichia coli infection. In this present case report will
describe a patient with acute lobar nephronia caused by Enterobacter cloacae.
Case
report:
A
65-year-old woman first presented with a three-day history of fever (38.4°C),
nausea and vomiting. She had no acute urinary symptoms or prior urological
history. Her medical history included Type 2 diabetes with no known end-organcomplications and hypertension. Her regular medications included Metformin 1000
mg twice a day, Gliclazide modified release 60 mg once a day and Irbesartan 300
mg once a day.she was febrile and tachycardic (pulse of 100 beats/min).
Her blood pressure was 125/75 mmHg, respiratory rate was 16 breaths/min and
oxygen saturation was 96% on room air. Examination of her chest revealed normal
findings. Examination of her abdomen and pelvis did not reveal any focus of
tenderness. However urinalysis was positive for nitrites and leucocyte
esterase.
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