1/3. Acute focal bacterial nephritis in an 8-year-old .Acute focal bacterial nephritis or acute lobar nephronia is an acute localized non-liquefactive bacterial kidney infection. Clinically, it may develop as an abscess and present as acute pyelonephritis but is distinguishable by the presence of a focal mass on imaging studies. The authors report the case of an 8-year-old girl with fever up to 39 degrees C and left flank pain of 6 days duration. On physical examination, she had nothing remarkable except tenderness and knocking pain over the left costovertebral angle. Post-contrast abdominal computed tomography revealed several wedge-shaped hypodense lesions in the left kidney. urine culture grew escherichia coli. Acute focal bacterial nephritis was diagnosed. The patient was treated with antibiotics and discharged on the 12th day of hospitalization.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/3. Imperforate hymen complicated with pyocolpos and lobar nephronia.An imperforate hymen is not a rare condition in female newborns, but is often ignored in a genital examination by physicians. Lobar nephronia is a rare condition in pediatric patients that can be screened by ultrasound or computed tomography to distinguish it from a renal abscess. Treatment for lobar nephronia requires at least 14 days of antimicrobial therapy and a follow-up assessment by renal ultrasonography or dimercaptosuccinic acid scan. We report an unusual case of a 2-year-old girl with an imperforate hymen and pyocolpos. The pyocolpos compressed the left lower ureter to cause hydroureter, hydronephrosis, and nephronia. Partial hymenotomy was performed to drain the pus, and antibiotics were administered for a total of 3 weeks. There was a good outcome. This case demonstrates the need to perform a full physical examination, particularly a genital examination, in newborns. Further, if gynecologic pathology is suspected, then urologic screening studies are recommended to rule out potential associated anomalies.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/3. multiple myeloma and gastric carcinoma. Possible late effects of limited abdominal X-irradiation.A man, aged 34, was treated in 1954 for duodenal ulcer by antroduodenectomy followed by X-irradiation to the stomach in a dose of 2,000 rads. Over two decades, he developed several conditions attributable to the previous irradiation, including the physical appearances of premature ageing, shrinkage of the left kidney due to irradiation nephritis, immune deficiency, multiple myeloma of IgA type, and lastly, carcinoma of the stomach. The kidneys, especially the left, the bone marrow and stomach would have been in the field of X-irradiation. These effects of local X-irradiation are discussed in relation to the known effects of total body irradiation in causing decreased longevity in animals and inducing cancer in man.- - - - - - - - - - ranking = 0.045764963794592keywords = physical (Clic here for more details about this article) |