A case of pediatric kidney abscess caused by Bacteroides fragilis

doi:10.11958/20252488

Abstract

Abstract:

Renal abscess is a rare type of urinary system infectious disease in children, and its clinical manifestations are often atypical, posing significant challenges to clinicians in diagnosis. This article reports a case of renal abscess. The child had intermittent fever and was eventually diagnosed with renal abscess. After anti-infection and puncture drainage, the child recovered. Metagenomic detection of pathogenic microorganisms in renal abscess revealed Bacteroides fragilis. This article discusses the issues of diagnosis, treatment, laboratory testing and prognosis.

Key words: Bacteroides fragilis, metagenome, abscess, kidney diseases, child

CLC Number:

R726.92

Figures/Tables 5

References 22

[1]	THASNEEM L, REDDY M, REDDY M, et al. Methicillin-resistant staphylococcus aureus renal abscess unmasks human immunodeficiency virus infection in an adolescent:A case report[J]. Cureus, 2025, 17(7):e87112. doi:10.7759/cureus.87112.
[2]	SUN J, SHI L, YE L, et al. Pediatric renal abscess:clinical analysis and literature review[J]. Front Pediatr, 2025,13:1407437. doi:10.3389/fped.2025.1407437.
[3]	BUSCHEL H, LEUNG P, STALEWSKI H, et al. Renal abscesses in children:an 11-year retrospective study and review of the literature[J]. ANZ J Surg, 2022, 92(12):3293-3297. doi:10.1111/ans.17943.
[4]	CHEN C Y, KUO H T, CHANG Y J, et al. Clinical assessment of children with renal abscesses presenting to the pediatric emergency department[J]. BMC Pediatr, 2016, 16(1):189. doi:10.1186/s12887-016-0732-5.
[5]	LIU X Q, WANG C C, LIU Y B, et al. Renal and perinephric abscesses in West China Hospital:10-year retrospective-descriptive study[J]. World J Nephrol, 2016, 5(1):108-114. doi:10.5527/wjn.v5.i1.108.
[6]	王凯歌, 王筱雯, 黄霖, 等. 儿童肾脓肿24例临床分析[J]. 中华实用儿科临床杂志, 2024, 39(5):355-359.
	WANG K G, WANG X W, HUANG L, et al. Clinical analysis of pediatric renal abscess in 24 cases[J]. Chin J Appl Clin Pediat, 2024, 39(5):355-359. doi:10.3760/cma.j.cn101070-20230808-00079.
[7]	张瑄, 张碧丽, 王文红, 等. 儿童肾脓肿临床分析[J]. 中华实用儿科临床杂志, 2019, 34(15):1191-1192.
	ZHANG X, ZHANG B L, WANG W H, et al. Clinical analysis of renal abscess in children[J]. Chin J Appl Clin Pediatr, 2019, 34(15):1191-1192. doi:10.3760/cma.j.issn.2095-428X.2019.15.017.
[8]	罗添华, 张旭辉, 孟庆明, 等. 儿童肾脓肿的保守治疗[J]. 中华小儿外科杂志, 2021, 42(10):903-906.
	LUO T H, ZHANG X H, MENG Q M, et al. Conservative management of pediatric renal abscess[J]. Chin J Pediatr Surg, 2021, 42(10):903-906. doi:10.3760/cma.j.cn421158-20210104-00006.
[9]	ANGEL C, SHU T, GREEN J, et al. Renal and peri-renal abscesses in children:proposed physio-pathologic mechanisms and treatment algorithm[J]. Pediatr Surg Int, 2003, 19(1/2):35-39. doi:10.1007/s00383-002-0888-y.
[10]	LI E, HONG J, ZHOU M, et al. Percutaneous nephroscopy combined with ultrasound-guided negative-pressure suction for the treatment of perinephric abscess:a case series[J]. BMC Urol, 2022, 22(1):140. doi:10.1186/s12894-022-01091-8.
[11]	YILDIRIM G, KARAKAS H. Percutaneous catheter drainage in retroperitoneal abscesses:a single centre's 8-year experience[J]. Pol J Radiol, 2022,87:e238-e245. doi:10.5114/pjr.2022.115815.
[12]	周正兴, 许国胜, 刘伟, 等. X-perCT及超声引导穿刺引流个体化治疗方案在肾脓肿患者中的应用[J]. 国际泌尿系统杂志, 2023, 43(2):270-274.
	ZHOU Z X, XU G S, LIU W, et al. The application of X-perCT and ultrasound-guided puncture in the individualized treatment of renal[J]. International Journal of Urology and Nephrologyabscess, 2023, 43(2):270-274. doi:10.3760/cma.j.cn431460-20210618-00068.
[13]	TAN X, PAN Q, MO C, et al. Carbapenems vs alternative antibiotics for the treatment of complicated urinary tract infection:A systematic review and network meta-analysis[J]. Medicine(Baltimore), 2020, 99(2):e18769. doi:10.1097/MD.0000000000018769.
[14]	KAVRUK M, SOYALTıN E, ERFIDAN G, et al. The influence of non-E. coli or Extended-spectrum β-lactamase-producing bacterial growth on the follow-up procedure of infants with the first febrile urinary tract infection[J]. Indian J Pediatr, 2023, 90(7):677-682. doi:10.1007/s12098-022-04183-3.
[15]	GAO Q, WU S, XU T, et al. Emergence of carbapenem resistance in Bacteroides fragilis in China[J]. Int J Antimicrob Agents, 2019, 53(6):859-863. doi:10.1016/j.ijantimicag.2019.02.017.
[16]	DUMONT Y, BONZON L, MICHON A L, et al. Epidemiology and microbiological features of anaerobic bacteremia in two French university hospitals[J]. Anaerobe, 2020,64:102207. doi:10.1016/j.anaerobe.2020.102207.
[17]	CLSI. Clinical and Laboratory Standards Institute. M100:Performance standards for antimicrobial susceptibility testing[M/OL]. 35th ed. Wayne: Clinical and Laboratory Standards Institute, 2025[2025-07-10].https://clsi.org/standards/products/microbiology/documents/m100/.
[18]	ISHAK N, ABDUL WAHAB Z, AMIN NORDIN S, et al. Susceptibility patterns of anaerobes isolated from clinical specimens in tertiary Hospital, Malaysia[J]. Malays J Pathol, 2020, 42(2):245-252.
[19]	张峻梅, 杨莉莉, 刘敏, 等. 临床感染标本厌氧菌质谱鉴定及临床特征[J]. 四川医学, 2024, 45(9):978-982.
	ZHANG J M, YANG L L, LIU M, et al. Mass spectrometry identification and clinical characteristics of anaerobic bacteria in clinical infection specimens[J]. Sichuan Medical Journal, 2024, 45(9):978-982. doi:10.16252/j.cnki.issn1004-0501-2024.09.010.
[20]	WU Z C, FENG H X, WU L, et al. Antimicrobial resistance pattern of the Bacteroides fragilis group strains isolated at a teaching hospital in China[J]. Acta Microbiol Immunol Hung, 2025, 72(1):59-67. doi:10.1556/030.2025.02400.
[21]	FLORISSON M, ACAR Z, HOLZKNECHT B J, et al. A seemingly considerable increase in antimicrobial resistance in the Bacteroides fragilis group from blood cultures - the second national study in Denmark[J]. Infect Dis(Lond), 2025, 57(4):316-321. doi:10.1080/23744235.2024.2425715.
[22]	中华医学会检验医学分会临床微生物学组, 中华医学会微生物学与免疫学分会临床微生物学组, 中国医疗保健国际交流促进会临床微生物与感染分会. 宏基因组高通量测序技术应用于感染性疾病病原检测中国专家共识[J]. 中华检验医学杂志, 2021, 44(2):107-120.
	Clinical Microbiology Group of Chinese Society of Laboratory Medicine, Clinical Microbiology Group of Chinese Society of Microbiology and Immunology, Society of Clinical Microbiology and Infection of China International Exchange and Promotion Association for Medical and Healthcare. Chinese expert consensus on metagenomics next-generation sequencing application on pathogen detection of infectious diseases[J]. Chin J Lab Med, 2021, 44(2):107-120. doi:10.3760/cma.j.cn114452-20201026-00794.

类型	种
类型	中文名		检出序列数		基因组覆盖度/%
革兰阴性菌	脆弱拟杆菌		178 344		71.14
革兰阳性菌	口腔消化链球菌		18 344		45.77
革兰阳性菌	咽峡炎链球菌		36		0.36
类型		属
类型		拉丁名		检出序列数		相对丰度/%
革兰阴性菌		Bacteroides		182 361		82.45
革兰阳性菌		Peptostreptococcus		18 873		8.53
革兰阳性菌		Streptococcus		110		0.05

类型	种
类型	中文名		检出序列数		基因组覆盖度/%
革兰阴性菌	脆弱拟杆菌		178 344		71.14
革兰阳性菌	口腔消化链球菌		18 344		45.77
革兰阳性菌	咽峡炎链球菌		36		0.36
类型		属
类型		拉丁名		检出序列数		相对丰度/%
革兰阴性菌		Bacteroides		182 361		82.45
革兰阳性菌		Peptostreptococcus		18 873		8.53
革兰阳性菌		Streptococcus		110		0.05