During the past decade new techniques such as computed tomography (CT) and ultrasonography have been reported to have changed the diagnostic investigation and treatment of renal
abscess in adults. To evaluate whether similar changes have taken place in the pediatric age group, a retrospective study of all patients seen between 1979 and 1989 was performed. Seven patients, 0.8 to 14 (mean, 9) years old, with renal
abscesses in eight kidneys were identified. Ultrasound and computed tomography proved to be the most valuable diagnostic tools, revealing the diagnosis by showing a hypoechoic or hypodense mass. All patients had an initial trial of intensive
antibiotic treatment, which led to resolution of the
abscesses in two of the eight kidneys. In all other cases the
abscesses were additionally drained, which was done surgically in two and by ultrasonography- or CT-guided percutaneous drainage in four patients.
Abscess cultures grew Staphylococcus aureus (three), Escherichia coli (one) and Salmonella Group B (one) and were sterile in one case. Drainage was unsuccessful in only one patient, who subsequently underwent
nephrectomy for uncontrolled
infection of a diffusely damaged kidney. We conclude that the diagnosis of renal
abscesses is greatly facilitated by ultrasonography and CT and that most patients can be cured without operation by
antibiotics and, if necessary, by additional percutaneous drainage.