{"created":"2023-06-19T10:21:48.533982+00:00","id":777,"links":{},"metadata":{"_buckets":{"deposit":"548dbac8-4eed-445d-8c82-8da361d0d439"},"_deposit":{"created_by":12,"id":"777","owners":[12],"pid":{"revision_id":0,"type":"depid","value":"777"},"status":"published"},"_oai":{"id":"oai:saitama-med.repo.nii.ac.jp:00000777","sets":["9:7:125"]},"author_link":["2587","2588","2594","2591","2589","2592","2593","2595","2596","2590"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-08","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"18","bibliographicPageStart":"11","bibliographicVolumeNumber":"47","bibliographic_titles":[{"bibliographic_title":"埼玉医科大学雑誌"},{"bibliographic_title":"Journal of  Saitama Medical University ","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"腎膿瘍は腎実質に液状化を伴う腫瘤性病変を特徴とする局所性感染症で,急性腎盂腎炎(acute pyelonephritis:APN)より重篤な上部尿路感染症(urinary tract infection:UTI)である.腎瘢痕を形成するリスクが高く,迅速かつ的確に診断後,ただちに抗菌薬治療を開始することが重要である.小児期に発症する腎膿瘍は稀で,その診断や治療にかかわる臨床像は十分に明らかではない.私たちは小児期発症腎膿瘍の早期診断の要点を明らかにするため,2014年4月から4年間に当科に入院した腎膿瘍3例を報告するとともに,同時期に発症したAPN112例と臨床像を比較した.結果:腎膿瘍3例の発症時年齢は7-13歳,入院・診断までの期間は発症後3-13日,2例で1週間以上を要した.初発時症状は発熱以外の特異的症状に乏しく,入院時の白血球,C反応性蛋白は高値で細菌感染症が疑われたが,全例に膿尿はなく尿培養は陰性でUTIと診断する尿所見に乏しかった.経過中の下部尿路症状からUTIを鑑別に挙げ,腹部造影コンピュータ断層撮影で液体貯留を伴う嚢胞性腫瘤を認め腎膿瘍と診断した.経静脈的広域抗菌薬投与で全例が速やかに解熱し,回復期の排尿時膀胱尿道造影で膀胱尿管逆流を認めた2例に逆流防止術が施行された.全例に病巣に限局した腎瘢痕を認めた.APN群と比較して,小児の腎膿瘍は,APN群の発症時年齢0.42歳に対し年長で発症すること,APN群の入院まで発症後2.0日に対し診断までの時間が長いこと,APN群の尿培養陽性率78.6%に対し,腎膿瘍は検尿異常を認めなかった.結論:腎膿瘍3例は画像以外の所見から腎実質性の局所性感染症を示唆する臨床所見が乏しく,年長児の感染源が不明な発熱患者には膿尿陰性でもUTIを否定せず積極的に画像精査を考慮すべきと考えた.(著者抄録)\n\nRenal abscesses are a serious urinary tract infection and relatively uncommon in children but may result in prolonged hospital stays. A diagnosis is not readily apparent before hospitalization, as symptoms are often insidious and nonspecific. To evaluate the diagnostics and minimize scarring, we herein report three cases of renal abscess compared with 112 cases of acute pyelonephritis (APN) admitted to our hospital for treatment from April 1, 2014, through March 31, 2018. The 3 patients (1 boy and 2 girls) with computed tomography (CT)-diagnosed renal abscesses ranged from 8 to 13 years old. Compared with the APN patients, the renal abscess patients showed significantly long durations of a fever and admission. The renal abscess patients were also significantly older than the APN patients. Regarding the clinical features of these patients, a fever was noted in all patients. The duration of the preadmission fever was 3–13 days. Biochemically, the C-reactive protein level was 3.58–17.75 mg/L, and no patient had positive blood and urine cultures. Intravenous antibiotics was effective and do not require drainage. Two cases had vesicoureteral reflux (VUR), and all cases had scarring. In contrast, urinary white blood cells were positive in 83% of APN patients, and positive urine cultures were noted in 78.6%, making the diagnosis uncomplicated. The diagnosis of renal abscess is impossible by diagnostic imaging alone. We concluded that renal abscesses must be assumed, especially in children with a prolonged fever and a high C-reactive protein level. For the early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or a CT.","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"埼玉医科大学医学会"}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"埼玉医科大学雑誌"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"http://www.saitama-med.ac.jp/jsms/vol47/jsms47_011-018.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN0009506X","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-5074","subitem_source_identifier_type":"ISSN"}]},"item_10001_text_24":{"attribute_name":"記事区分","attribute_value_mlt":[{"subitem_text_value":"症例報告 / Case report"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"藤野, 美里"},{"creatorName":"フジノ, ミサト","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2587","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"秋岡, 祐子"},{"creatorName":"アキオカ, ユウコ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2588","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"荒尾, 正人"},{"creatorName":"アラオ, マサト","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2589","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"飛田和, えりか"},{"creatorName":"ヒダワ, エリカ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2590","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"徳山, 研一"},{"creatorName":"トクヤマ, ケンイチ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2591","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Fujino, Misato","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2592","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Akioka, Yuko","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2593","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Arao, Masato","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2594","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Hidawa, Erika","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2595","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Tokuyama, Kenichi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2596","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2021-10-28"}],"displaytype":"detail","filename":"jsms47_1_011-018.pdf","filesize":[{"value":"1.7 MB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"埼玉医科大学雑誌47巻1号11-18頁","url":"https://saitama-med.repo.nii.ac.jp/record/777/files/jsms47_1_011-018.pdf"},"version_id":"761a9012-98b5-4a60-833a-bbe502414448"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Cefmetazole(治療的利用)","subitem_subject_scheme":"Other"},{"subitem_subject":"Cefotaxime(治療的利用)","subitem_subject_scheme":"Other"},{"subitem_subject":"検尿","subitem_subject_scheme":"Other"},{"subitem_subject":"腎盂腎炎(診断)","subitem_subject_scheme":"Other"},{"subitem_subject":"*腎臓疾患(診断,薬物療法,合併症)","subitem_subject_scheme":"Other"},{"subitem_subject":"X線CT","subitem_subject_scheme":"Other"},{"subitem_subject":"*尿路感染症(診断,薬物療法,合併症)","subitem_subject_scheme":"Other"},{"subitem_subject":"*膿瘍(診断,薬物療法,合併症)","subitem_subject_scheme":"Other"},{"subitem_subject":"排尿","subitem_subject_scheme":"Other"},{"subitem_subject":"瘢痕(病因)","subitem_subject_scheme":"Other"},{"subitem_subject":"不明熱","subitem_subject_scheme":"Other"},{"subitem_subject":"膀胱尿管逆流(X線診断,外科的療法,合併症)","subitem_subject_scheme":"Other"},{"subitem_subject":"発病年齢","subitem_subject_scheme":"Other"},{"subitem_subject":"Meropenem(治療的利用)","subitem_subject_scheme":"Other"},{"subitem_subject":"細菌培養","subitem_subject_scheme":"Other"},{"subitem_subject":"治療までの期間","subitem_subject_scheme":"Other"},{"subitem_subject":"膀胱造影","subitem_subject_scheme":"Other"},{"subitem_subject":"*腎膿瘍(診断,薬物療法,合併症)","subitem_subject_scheme":"Other"},{"subitem_subject":"腎瘢痕(病因)","subitem_subject_scheme":"Other"},{"subitem_subject":"腹部CT","subitem_subject_scheme":"Other"},{"subitem_subject":"ヒト","subitem_subject_scheme":"Other"},{"subitem_subject":"小児(6〜12)","subitem_subject_scheme":"Other"},{"subitem_subject":"青年期(13〜18)","subitem_subject_scheme":"Other"},{"subitem_subject":"男","subitem_subject_scheme":"Other"},{"subitem_subject":"女","subitem_subject_scheme":"Other"},{"subitem_subject":"renal abscesses","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"acute pyelonephritis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"VUR","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"children","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"小児期発症の腎膿瘍3例　急性腎盂腎炎の臨床像との比較","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"小児期発症の腎膿瘍3例　急性腎盂腎炎の臨床像との比較"},{"subitem_title":"Three cases of pediatric renal abscess: A clinical comparison of renal abscess with acute pyelonephritis","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"12","path":["125"],"pubdate":{"attribute_name":"公開日","attribute_value":"2021-10-28"},"publish_date":"2021-10-28","publish_status":"0","recid":"777","relation_version_is_last":true,"title":["小児期発症の腎膿瘍3例　急性腎盂腎炎の臨床像との比較"],"weko_creator_id":"12","weko_shared_id":-1},"updated":"2023-06-19T10:29:44.424574+00:00"}