Suppurative Pyelonephritis in a Newborn with Congenital Urinary Tract Malformation: Diagnostic Challenges and Management Approach: a Case Report

Purulent kidney lesions occupy a special place in pediatric practice, yet only isolated or small series of cases have been reported to date. This paper presents a clinical case of a 12-day-old patient admitted with lethargy, feeding refusal, fever, and depressed consciousness. Epidemiological history revealed prolonged household contact with varicella. Examination revealed enlargement of the right kidney with multiple diffuse focal changes in the parenchyma, enlargement of the left kidney, multiple microabscesses, signs of ureterohydronephrosis, and bladder wall thickening. Surgical revision of the right kidney was performed via a translumbar approach, with placement of a subcapsular drain and insertion of a cystostomy. The patient received antibacterial, antiviral, and infusion therapy, along with immunological support. Discharge from hospital occurred on day 32 of admission. At follow-up, at the age of 5 months, the Foley cystostomy catheter was removed, and a universal 5Ch ureteral stent was placed in the left ureter, which was removed at 6 months. This clinical case of suppurative pyelonephritis in a newborn with a congenital urinary tract malformation demonstrates the need for staged treatment and formation of a multidisciplinary team of specialists — neonatologists, pediatric surgeons, pediatric urologists, nephrologists, and clinical pharmacologists — for timely diagnosis and successful management.