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P660 Abscess of the kidney, a diagnosis not always evident!

Introduction Kidney abscess is defined as a suppurate lesion collected in the renal parenchyma. It is a rare pathology in pediatrics. We report four cases of renal suppuration. Material and method This is a retrospective study over a period of 9 years (2010-2018) collaging all cases of renal abscess having been hospitalized in the pediatric ward, emergency and pediatric resuscitation of Sfax. Results We collected 4 cases of renal abscess. These were two boys and two girls. The average age was 5 ½ years with extremes ranging from 3 ½ years to 10 years. The delay of diagnosis was estimated at an average of 19 days. Fever and lumbar pain were reported in three cases. In the other case, it was a respiratory chart. The urinary and digestive signs were variable or absent in one case. Hyperleukocytosis with a positive CRP were constant. The cytobacterioligical urine exam practiced systematically was positive in 2 cases by isolating an Enterobacter Cloacoe in one case and an E Coli in another case, it revealed aseptic leukocyturia in one case and it showed no abnormality in the other case. The diagnosis of abscess was made thanks to the ultrasound-CT abdominal pairing performed in all patients. All patients were treated with intravenous antibiotic therapy. Percutaneous drainage was performed in one patient due to the inefficacy of antibiotic alone. The evolution was marked by apyrexia and improvement of other clinical and biological signs. Conclusion The treatment of the kidney abscess is based on antibiotic therapy with or without percutaneous or surgical drainage depending on the size of the abscess and the clinical course.