Abstract
A9-year-old girl with acute renal failure associated with pyelonephritis caused by Salmonella O9 is reported. She started to have fever, left flank pain and gross hematuria and referred to us for further examination and treatment. Urine culture was positive for Salmonella O9 and leukocyturia was found. A diagnosis of left pyelonephritis was made. She also contracted acute renal failure (ARF) without oligouria which improved by conservative treatment. Urological examinations showed a vesicouretheral reflux (VUR) at the left ureter and a stenosis of extra urethral orifice. After urethrotomy VUR disappeared. A transient elevation of fractional excretion of sodium and prolonged proteinuria after recovery of ARF indicated a presence of renal causes as well as pre-renal causes. It is well known that Salmonella enterocolitis is occasionally complicated by pre-renal ARF. However, ARF induced by Salmonella infection without severe diarrhea is quite rare and ARF caused by acute pyelonephritis is also uncommon. We suppose that severe inflammation and/or diclofenac might be the risk factors of ARF in our patient.
