Objectives: AFBN is a localized bacterial infection of the kidney presenting itself as an inflammatory mass without drainable pus. It is being increasingly recognized by current urographic imaging. It is important not to confuse AFBN with renal abscess or neoplasm as this might lead to inappropriate surgical therapy. This study was per- formed to find out clinical aspects of AFBN. Methods: From Jan. 1992 to Dec. 1993 in Dongkang hospital with a capacity of 600beds, 24cases thought to fulfill the sonographic criteria for AFBN were reviewed retrospectively. Results: 1) The overall male to female ratio was 4:20, and the age distribution ranged from 7 to 78years, and the mean age of overall patients was 35.7±15.9 years. 2) Underlying conditions could be identified in 13subjects(54.2%); pregnancy(N=5), diabetes mellitus (N=2), renal stone(N=2), previous urinary tract infection(N=2), etc. in order of frequency. 3) The duration of preadmission illness was 6.3±5.9 days(1-30). 4) Cardinal symptoms and signs were chills (100%), flank pain(83%), costovertebral angle tenderness(100%), fever(88%), pyuria(88%) and leukocytosis(79%). Urine culture revealed E. coli positive in 10out of 23patients tested: one patient had E. coli positive in blood culture. 5) In total 24 cases, There were two cases accompanying with intrarenal abscesses and one case progressing to intrarenal abscess. 6) All patients were admitted and treated with antibiotics. Fever and flank pain lasted 3.5±0.5 days and 4.1±2.2 days, respectively. No patient underwent surgical procedures. The duration of hospitalization was 8.9±4.4 days(2~20). Conclusion: AFBN is a focal variant of acute pyelonephritis with single area of suppuration. It is not an infrequent disease entity which has relatively good prognosis once diagnosed accurately in its early stage. With delayed treatment or inappropriate therapy, it probably progress to intrarenal abscess.
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