Akademik Veri Yönetim Sistemi
39TH ANNUAL MEETING OF THE EUROPEAN SOCIETY FOR PAEDIATRIC INFECTIOUS DISEASES, Geneve, İsviçre, 24 Mayıs 2021, sa.620
Background: Infections are a major contributor to morbidity and mortality in end-stage renal disease patients. It should be noted that the immune dysfunction in uremia is associated with alterations in the two major branches of the immune system, innate and adaptive immunity.
Case Presentation Summary:An 8-year-old girl with chronic renal failure caused by vesicoureteral reflux and is undergoing peritoneal dialysis, brought with fever, erythema, and pain in the gluteal area. Blood tests showed leukocyte 18.900/mm3 , C-reactive protein 239 mg/L, procalcitonin 9.41 ng/mL. Left gluteal skin and lower skin tissue were edematous and 57x24 mm abscess formation was seen in ultrasonography. Intravenous ampicillinsulbactam and clindamycin treatment was given to the patient. In a clinical follow-up, gluteal erythema became larger on physical examination, leukocytosis was detected in peritoneal dialysis sample and thought peritonitis. Widespread inflamed tissue including left obturator muscle, presacral area, mesorectal fascia, and 8x5x6 cm abscess formation leading from left ischioanal area to left gluteal area was seen in magnetic resonance imaging with contrast. The abscess was drained by a pediatric surgeon. Treatment was changed as intravenous vancomycin and meropenem, intraperitoneal cephazolin, and ceftazidime. After drainage and broad-spectrum antimicrobial treatment, rapid remission was seen and the patient was discharged after the 10th day of hospitalization.
Learning Points/Discussion: Immune dysfunction according to renal failure increased the risk for
infections for patients. The abscess is an uncommon clinical situation, near location to the peritoneal area
should thought us peritonitis.