[Acute lobar nephronia: Diagnosis, treatment and prognosis].

Acute lobar nephronia is a focal form of acute bacterial renal infection. The prevalence of this disease is low. We report four cases of acute lobar nephronia. Three patients were diagnosed among 77 patients admitted to hospital for acute pyelonephritis. The fourth case was atypical and associated with epidermolysis bullosa. All cases were diagnosed by renal ultrasonography and the diagnosis was confirmed by computed tomographic examination in two patients with poor clinical course. A small abscess was detected in one patient. Urine cultures were positive in three of the four patients. Acute lobar nephronia is a radiological diagnosis and requires aggressive treatment and strict follow-up due to the risk of renal abscesses. Because the clinical manifestations are insidious and laboratory findings can be contradictory, this entity should be suspected in patients with poor clinical course or alterations on renal ultrasonography. Medical treatment is usually sufficient and prognosis is generally good.