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Purpose The aim of this study is to evaluate the clinical utility of late 6-month dimercapto-succinic acid (DMSA) renal scan in predicting vesicoureteral reflux (VUR) and long-lasting renal scars in children with first acute pyelonephritis (APN). Methods A retrospective case study of children admitted with APN from January 2010 to July 2017 was performed. The study included patients with voiding cystourethrography (VCUG) and acute and late 6-month DMSA scan. We analyzed the clinical, laboratory and imaging findings of patients with and without late cortical defects at 6 months and those with or without VUR. Results Among 145 children with APN, 50 (34.5%) had cortical defects on the late DMSA renal scan and 60 (41.4%) showed VUR. Thirteen of 38 (34.2%) children undergoing 18-month DMSA renal scan showed a long-lasting renal scars. Compared with children without late cortical defects, patients with late 6-month cortical defects had a higher incidence of VUR and long-lasting renal scars, and relapse of UTI (all P

Streptococcus agalactiae or group B streptococcus (GBS) is associated with infections in neonates and pregnant women. Herein, we describe a rare case of GBS renal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1 diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratory findings included leukocytosis and increased C-reactive protein level and erythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysis showed no pyuria. Renal sonography revealed parenchymal swelling in the right kidney. The patient was administered intravenous cefotaxime. Urine and blood cultures were negative. Fever seemed to improve, but the following day, she complained of abdominal pain and fever. Antibiotic was switched to imipenem, and abdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, and bilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscess was performed. Culture from the abscess was positive for GBS, and fever subsided 2 days after the drainage. She was discharged with oral cefixime. The clinical course of urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBS can be a cause of UTIs. Prompt diagnosis and management are necessary to prevent complications in patients showing atypical courses.