Focal pyelonephritis-diagnostic and therapeutic problems

We present three patients with focal pyelonephritis (FP): one child with typical clinical symptoms, the other with suspected acute appendicitis, and the third with no symptoms of disease. In all three patients, besides a complete case history, clinical examination and laboratory findings, renal sonography and renal Doppler sonography were performed and diagnosed focal pyelonephritis. The sonography findings were confirmed by renal scintigraphy. In one child excretory urography was performed in another hospital, with a normal finding. We have shown that for the diagnosis of focal pyelonephritis two diagnostic procedures were necessary: sonography and scintigraphy. The treatment should be antibiotics over 2-3 weeks. With an early diagnosis and adequate therapy, the prognosis for focal pyelonephritis is good.