CASE REPORT article
Front. Pediatr.
Sec. Pediatric Nephrology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1625781
Xanthogranulomatous Pyelonephritis in a 47-Day-Old male infant: A case report
Provisionally accepted
- 1Beijing Children’s Hospital, Capital Medical University, Beijing, China
- 2Baoding Hospital of Beijing Children′s Hospital, Baoding, China
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Background: Xanthogranulomatous pyelonephritis (XGP), a rare granulomatous renal disease linked to bacterial infection (e.g., Escherichia coli), presents challenges in pediatric diagnosis, especially in infants, due to overlap with neoplastic renal masses like Wilms tumor.Case Summary: A 47-day-old male infant with fever, elevated inflammatory markers (WBC 13.94×10⁹/L, CRP 110.43 mg/L), and urinary leukocytes/hematuria showed a left renal mass (1.7×1.8×2.1 cm) on imaging. Biopsy revealed histiocytic-neutrophilic infiltration with focal necrosis, and metagenomic sequencing identified dominant E. coli. Antibiotic therapy (cefoperazone-sulbactam followed by cefdinir) induced regression (1.1×0.8×1.1 cm at 2 weeks). Elevated AFP (888.27 ng/mL) normalized, excluding malignancy.Conclusion: This case highlights XGP as a critical differential diagnosis for febrile infants with renal masses. Integration of histopathology, metagenomic sequencing, and prolonged follow-up confirms that focal XGP can be managed successfully with targeted antibiotics, avoiding nephrectomy.
Keywords: xanthogranulomatous pyelonephritis, Infant, metagenomic sequencing, Escherichia coli, antibiotics
Received: 09 May 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Jiang, Chang, Fu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yeping Jiang, Beijing Children’s Hospital, Capital Medical University, Beijing, China
Hui Wang, Beijing Children’s Hospital, Capital Medical University, Beijing, China
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