Fístula nefrobronquial en paciente pediátrico. Caso clínico
Date
2014
Type:
Artículo
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4
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Journal Title
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Volume Title
Publisher
Sociedad Argentina de Pediatría
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Abstract
Nephrobronchial fistula is a rare complication of kidney infections, usually occurring in adult patients with xanthogranulomatous pyelonephritis and very occasionally in children. We reported a 12-year-old girl, with a history of myelomeningocele and recurrent urinary tract infection, who presented with a four-week fever, cough and dyspnea, developing septic shock and presenting flood of airway by pus which caused cardiac arrest. A diagnosis of left perirenal extensive collection was established by abdominal computed tomography (CT). The patient first had antibiotic therapy and percutaneous drainage was performed draining pus and air. Thoracic and abdominal CT scan was performed corroborating transdiaphragmatic fistula. Total nephrectomy was performed. The patient showed gradual improvement after surgery and total regression of symptoms. Pathologic examination concluded chronic pyelonephritis. This case report illustrates a rare complication in children, the importance of early diagnosis of urinary tract infection in patients with comorbidities and of exhibiting a high index of suspicion to a potentially lethal complication.
Description
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Citation
Arch Argent Pediatr. 2014 Aug;112(4):e156-159
Keywords
chronic pyelonephritis, nephrobronchial fistula, nephrolithiasis, urinary tract infection