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July 1994

Radiological Cases of the MonthCase 1

Arch Pediatr Adolesc Med. 1994;148(7):719-720. doi:10.1001/archpedi.1994.02170070057009

A 938-G INFANT was born at 25 weeks' gestation by spontaneous vaginal delivery to a mother with chorioamnionitis. The infant was treated empirically with ampicillin and gentamicin for 7 days. Initial respiratory distress syndrome progressed to bronchopulmonary dysplasia; dexamethasone treatment was then instituted on day 18. Two weeks later, a urine culture grew Staphylococcus aureus, and this infection was treated with vancomycin for 10 days, after which a renal ultrasonographic examination showed right hydronephrosis and a normal left kidney. The serum creatinine level was 44 μmol/L (0.5 mg/dL) and the serum urea nitrogen level was 7.5 mmol/L of urea (21 mg/dL). Ten days later, a repeated microscopic urinalysis showed yeast and a urine culture grew Candida albicans. The right renal hydronephrosis was resolving, but the right kidney was smaller than the left (Figure 1). The serum creatinine level rose to 212 μmol/L (2.4 mg/dL), and intravenous amphotericin B treatment was