2023 Volume 36 Pages 33-40
The case described here is a six-year-old girl presenting with fever and abdominal pain without any history of urinary tract infection. On interviewing the patient, it emerged that she had developed several problems with micturition after being reprimanded by her father for failing to urinate in the toilet. A urine culture test performed at the time of admission revealed only a small amount of bacteria. Nonetheless, a urinary tract infection was suspected based on the clinical interview. Accordingly, contrast-enhanced CT was performed, revealing acute focal bacterial nephritis and a renal abscess. There were no apparent neurological abnormalities in MRI of the spine, suggesting that the underlying disease may have been Hinman-Allen syndrome. Oral treatment was considered, but the patient’s urinary habits improved solely with appropriate training, and no recurrence of urinary tract infection has been observed to date. This is a rare case of a renal abscess developing without an underlying organic disease, and emphasizes the necessity of interviewing school-age children regarding their micturition habits when they first develop any signs of urinary tract infection. Currently, there are only a few detailed reports on urination training. Because this syndrome may be cured with lifestyle guidance alone, without recurrence in this patient, here we report on the details of the actual training procedure.
