First documented extended-spectrum β-lactamase producing Escherichia coli renal abscess in Lebanon: a case report
Abstract
Introduction and importance: Renal abscesses in children are rare, and those caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli are even rarer. This report presents the first case of an ESBL-producing E. coli renal abscess via a possible ascending route in a previously healthy child in Lebanon.
Case presentation: A 10-year-old girl presented with high-grade fever, abdominal pain, and vomiting. Urine culture revealed an ESBL-producing E. coli infection, and imaging revealed multiple abscesses in the right kidney. Despite antibiotic treatment, the fever persisted, with abscess >3 cm requiring percutaneous drainage. After this procedure, the patient improved and was discharged with antibiotics. Follow-up imaging confirmed full resolution of all abscesses, and the voiding cystourethrogram was negative.
Clinical discussion: Clinical diagnosis of a renal abscess in a previously healthy child without structural abnormalities or recent antibiotic use requires a high index of suspicion. Based on the literature and our case, we propose a diagnostic and management algorithm to guide evaluation and treatment.
Conclusion: This case highlights the challenges of diagnosing and treating pediatric renal abscesses caused by ESBL-producing bacteria, marking the first reported case in Lebanon. The algorithm proposed is clinically useful but requires further validation in larger cohorts.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.