XANTHOGRANULOMATOUS PYELONEPHRITIS - REPORT OF NONSURGICAL MANAGEMENTOF A CASE AND REVIEW OF THE LITERATURE

A case of focal xanthogranulomatous pyelonephritis (XPN) in a child, s uccessfully cured with antibiotics only, is presented, and this report is followed by a review of the literature on XPN in both children and adults. XPN is a rare inflammatory disease of the kidney. Factors str ongly implicated in the development of XPN are genitourinary obstructi on and urinary tract infection, although other contributing factors ha ve been suggested. The clinical presentation of the disease is remarka bly nonspecific and variable; it therefore is frequently misdiagnosed as other, more common diseases that cause focal or diffuse renal masse s, including renal neoplasms, abscesses, and tuberculosis. Diagnosis r equires acquisition of renal tissue for special pathological staining. The long-standing mainstay of therapy for XPN has been nephrectomy or partial nephrectomy. However, this report and other recent reports of the successful medical management of focal XPN suggest that a trial o f antibiotics prior to surgery is warranted in cases of focal XPN.