Acute Bacterial Nephritis in an 8-Year-Old Boy Presenting with Abdominal Pain: A Diagnostic Challenge

Case Report

Acute Bacterial Nephritis in an 8-Year-Old Boy Presenting with Abdominal Pain: A Diagnostic Challenge

  • Cindy Gomes 1*
  • Claúdia Rodrigues 1
  • Ana Isabel Duarte 2

1Department of Pediatrics, Unidade Local de Saúde Médio Tejo, Torres Novas, Portugal.

2Department of Pediatrics, Unidade Local de Lezíria, Santarém, Portugal.

*Corresponding Author: Cindy Gomes, Department of Pediatrics, Unidade Local de Saúde Médio Tejo, Torres Novas, Portugal.

Citation: Gomes C, Rodrigues C, Duarte AI. (2026). Acute Bacterial Nephritis in an 8-Year-Old Boy Presenting with Abdominal Pain: A Diagnostic Challenge, International Clinical and Medical Case Reports, BioRes Scientia Publishers. 5(3):1-3. DOI: 10.59657/2837-5998.brs.26.064

Copyright: © 2026 Cindy Gomes, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: May 26, 2026 | Accepted: June 17, 2026 | Published: July 13, 2026

Abstract

Acute bacterial nephritis, also known as acute lobar nephronia or focal bacterial nephritis, is an uncommon localized infection of the renal parenchyma without liquefaction. It may mimic other causes of acute abdominal pain in children, particularly when urinary symptoms are absent. We report the case of an 8-year-old previously healthy boy presenting with high fever and right-sided abdominal/flank pain, initially interpreted as mesenteric adenitis. Persistent fever, worsening inflammatory markers, and absence of an obvious infectious focus prompted contrast-enhanced abdominal computed tomography, which revealed hypoperfused areas in the upper pole of the right kidney, consistent with acute bacterial nephritis. He improved with intravenous cefuroxime followed by oral cefuroxime-axetil, completing four weeks of therapy. Follow-up ultrasound and 99mTc-DMSA scintigraphy confirmed complete resolution without renal scarring. This case highlights the need to consider acute bacterial nephritis in children with persistent fever and abdominal pain, even without urinary complaints.


Keywords: acute lobar nephronia; acute bacterial nephritis; focal bacterial nephritis; urinary tract infection; abdominal pain; child

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