Objective

To investigate the clinical characteristics and treatment strategies of renal abscesses in children.

Methods

A total of 5 cases of pediatric renal abscess children（child 1-5）admitted to the Department of Pediatrics，General Hospital of Ningxia Medical University from January 2022 to December 2024 were included into study.A retrospective analysis was conducted on general information，clinical manifestations，laboratory tests，imaging findings，treatment plans，and outpatient follow-up results of these 5 children.This study was approved by the Ethics Committee of the General Hospital of Ningxia Medical University （Ethics Approval No.KYLL-2025-0152），and informed consents were obtained from the guardians of the children for their diagnosis and treatment.

Results

①Among the 5 children，3 cases were male and 2 cases were female，with ages ranging from 3 to 13 years.The clinical manifestations of the 5 children were primarily characterized by recurrent fever，with some children presenting with abdominal pain，vomiting，and urinary tract irritation signs.One child exhibited tenderness on renal percussion，while no other positive physical signs were observed.②Before treatment，all 5 children had elevated peripheral blood white blood cell count（WBC），C-reactive protein （CRP），and erythrocyte sedimentation rate （ESR）.Two children had increased urinary leukocytes，and one child had a positive urine culture，with the pathogen identified as Escherichia coli.③After admission，all 5 children underwent color Doppler ultrasound of the urinary system，enhanced CT of the kidneys，or MRI.Among them，left renal abscess was found in 3 children，and right renal abscess in 2 children.Upper pole abscess was present in 3 children，and lower pole abscess in 2 children.Three children had renal abscess diameters less than 3 mm，while 2 children had diameters greater than 3 mm.Three children exhibited hydronephrosis.Color Doppler ultrasound of the urinary system showed hypoechoic masses within the renal parenchyma with unclear borders，with diameters ranging from 1.7 to 5.0 cm.MRI of the kidneys revealed patchy abnormal signals within the renal parenchyma，with high signal intensity on diffusion-weighted imaging（DWI）and unclear borders；enhanced scanning showed heterogeneous enhancement of the lesions.④All children received conservative treatment.Initial treatment involved intravenous infusion of broadspectrum antibiotics （piperacillin-tazobactam，meropenem，or ertapenem）for anti-infection therapy.However，the therapeutic effect was unsatisfactory，leading to an upgrade in antibiotic treatment.⑤After discharge，all children continued oral antibiotic therapy for more than 14 days.Follow-up within 2 weeks after discharge showed complete resolution of renal abscesses without renal scar formation.No recurrence was observed during the outpatient follow-up period after discontinuation of medication.

Conclusions

The use of broad-spectrum antibiotics for the treatment of pediatric renal abscesses has proven to be effective and can be recommended as the first-line therapeutic approach.