title: [Nephrobronchial fístula in pediatric patient: case report].
abstract: Nephrobronchial fistula is a rare complication of kidney infections, usually occurring in adult patients with xanthogranulomatous pyelonephritis and very occasionally in children. We reported a 12-year-old girl, with a history of myelomeningocele and recurrent urinary tract infection, who presented with a four-week fever, cough and dyspnea, developing septic shock and presenting flood of airway by pus which caused cardiac arrest. A diagnosis of left perirenal extensive collection was established by abdominal computed tomography (CT). The patient first had antibiotic therapy and percutaneous drainage was performed draining pus and air. Thoracic and abdominal CT scan was performed corroborating transdiaphragmatic fistula. Total nephrectomy was performed. The patient showed gradual improvement after surgery and total regression of symptoms. Pathologic examination concluded chronic pyelonephritis. This case report illustrates a rare complication in children, the importance of early diagnosis of urinary tract infection in patients with comorbidities and of exhibiting a high index of suspicion to a potentially lethal complication.
authors: Área de Cuidados Críticos, Hospital Padre Hurtado.
authors: Daniela
authors: D
authors: Arriagada S
authors: Área de Cuidados Críticos, Hospital Padre Hurtado.
authors: Alejandro
authors: A
authors: Donoso F
authors: Centro de Investigación de Medicina Veterinaria, Escuela de Medicina Veterinaria, Facultad de Ecología y Recursos Naturales, Universidad Andrés Bello.
authors: Pablo
authors: P
authors: Cruces R
authors: Programa de Radiología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo.
authors: Jaime
authors: J
authors: Verdugo B
mesh_terms: D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D002648:Child; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D014552:Urinary Tract Infections / Q000150:complications