Non-iatrogenic nephro-pleural fistula in a child

A fistula between kidney and pleura is a rare entity, particularly in children. Fistulation mostly iatrogenic, following percutaneous nephrolithotomy has reported incidence of <1%. In the absence recent renal surgery diagnosis may be hampered by lack suspicion. However, Case pyelonephritis with ipsilateral pulmonary symptoms fistulation should considered. We present pediatric case nephro-pleural due to chronic pyelonephritis, as well review literature. highlight that etiology impact effectivity treatment. Surgery-related fistulas heal spontaneously optimal drainage urine combined antibiotic contrast, pyelonephritis-related (most common xanthogranulomatous pyelonephritis) frequently require additional debridement (partial) nephrectomy.