Dr. Ann Raes
Department of Pediatrics and Medical Genetics, Ghent University, Belgium
A 10 days old boy comes to your office for evaluation because he is much less interested in breast-feeding since one day. He started vomiting and has high fever. He is the product of a 39-week pregnancy. His mom is a 24 years old refugee and did not have prenatal care. The physical examination reveals a lower abdominal mass and a dribbling urinary stream is observed during micturition. He is clinically not toxic. His serum white blood cell counts and CRP are elevated. The urinalysis reveals 500 WBC/mm³. His serum creatinine is 2 mg/dl. The potassium is 5,7mg/dl. The abdominal ultrasound reveals a severe hydronephrosis in a right dysplastic kidney and a mild hydronephrosis on the left side. The bladder is distended, the bladderwall is thickened and the proximal urethra is dilated.