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Singh K, Greene J. Emphysematous Pyelonephritis in Cancer Patients: A Case Report With a Literature Review. Cureus 2024; 16:e65000. [PMID: 39161488 PMCID: PMC11333016 DOI: 10.7759/cureus.65000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2024] [Indexed: 08/21/2024] Open
Abstract
Emphysematous pyelonephritis (EPN) is a severe necrotising infection of the renal parenchyma which is rarely reported in cancer patients. We present a case of a 92-year-old man with urothelial carcinoma of the bladder who developed EPN after resection of the tumour. Septic shock developed and blood cultures grew extended-spectrum beta-lactamase (ESBL) Escherichia coli. Because of renal function decline with hematuria a non-contrast CT scan of the abdomen showed gas in the kidney and surrounding area consistent with EPN. After receiving appropriate antibiotics according to susceptibility testing, EPN was resolved based on a follow-up CT scan of the abdomen without requiring further surgical intervention. We review the literature and discuss the management of EPN in cancer patients.
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Affiliation(s)
- Karandeep Singh
- Internal Medicine, Government Medical College, Amritsar, Amritsar, IND
| | - John Greene
- Infectious Disease, Moffitt Cancer Center and Research Institute, Tampa, USA
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Newcomer JB, Myers CB, Chacon E, Kim JK, Raissi D. Percutaneous drainage for non-operative management of emphysematous pyelonephritis: Clinical characteristics and predictors of success. J Clin Imaging Sci 2022; 15:59. [PMID: 36601423 PMCID: PMC9805613 DOI: 10.25259/jcis_103_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022] Open
Abstract
Emphysematous pyelonephritis (EPN) is a necrotizing renal infection that can rapidly progress without urgent intervention. The purpose of this study was to evaluate the safety and efficacy of percutaneous nephrostomy (PN) in the management of EPN, as well as the relationship of outcomes with initial classification by the Huang-Tseng classification system and other prognostic factors such as thrombocytopenia. A retrospective review of medical records revealed seven patients with EPN treated with PN. Thirty-day survival rate was 86%, with the only mortality due to an arrhythmia secondary to underlying cardiomyopathy rather than a complication from EPN or PN. A single nephrostomy procedure served as definitive treatment in 3 patients (43%). Reintervention due to recurrence of EPN symptoms was required in 4 patients (57%), all of which initially presented with Class 3 disease or higher. Two of these four patients required nephrectomy, while the other two were successfully managed with a second drainage procedure without further recurrence of symptoms. PN appears to be a safe and generally effective management option for EPN, especially in patients who are considered poor surgical candidates. PN may serve as definitive treatment in hemodynamically stable patients with lower class of disease. In patients with higher class of disease, PN may be definitive treatment in patients who lack additional risk factors such as thrombocytopenia or serve as an effective bridge to nephrectomy.
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Affiliation(s)
- Jack Bailey Newcomer
- Department of Radiology, Medicine and Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, United States.,Corresponding author: Jack Bailey Newcomer, University of Kentucky College of Medicine, Lexington, United States.
| | - Charles Benjamin Myers
- Department of Radiology, Medicine and Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, United States
| | - Eduardo Chacon
- Department of Radiology, Medicine and Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, United States
| | - Joon Kyung Kim
- Department of Urology, Medicine and Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, United States
| | - Driss Raissi
- Department of Radiology, Medicine and Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, United States
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Jiya FB, Ibitoye PK, Jiya NM, Amodu-Sanni M, Mohammed Y, Aquib DM, Coker LK. Emphysematous pyelonephritis in an infant from Sokoto, north-western Nigeria. Afr J Lab Med 2021; 10:1181. [PMID: 34007815 PMCID: PMC8111630 DOI: 10.4102/ajlm.v10i1.1181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Emphysematous pyelonephritis is a life-threatening necrotising bacterial infection of the kidneys. It is rare among children and can be fatal if not promptly identified and treated. Case presentation A 7-month-old male infant presented to the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, on 12 November 2019 with a 5-day history of fever and vomiting, and a 3-day history of a progressively enlarging, left-side abdominal mass. There was associated excessive crying on micturition, refusal to feed and weight loss. He looked ill and was in respiratory distress, irritable, febrile (38.8 °C), moderately dehydrated and pale. His weight and length were 5.5 kg and 64 cm. He had a tender, firm and ballotable abdominal mass on the left flank measuring 8 cm × 10 cm. His pulse rate was 140 beats/min, blood pressure 60/40 millimetres of mercury and respiratory rate was 65 cycles/min. He had widespread coarse crepitations and normal heart sounds on chest auscultation. Management and outcome An initial diagnosis of sepsis was made. Other considerations were nephroblastoma and neuroblastoma. Ceftriaxone and blood transfusion were commenced with subsequent administration of intravenous fluids. Further radiologic investigations revealed emphysematous pyelonephritis. The patient had percutaneous drainage and extended spectrum β-lactamase-producing Escherichia coli (sensitive to meropenem) which was isolated from the aspirate culture after 48 h of incubation. Meropenem could not be commenced because of non-availability and high cost. The patient subsequently deteriorated and died from septic shock. Conclusion Emphysematous pyelonephritis has a fulminant course when not diagnosed promptly and treated adequately.
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Affiliation(s)
- Fatima B Jiya
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Paul K Ibitoye
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Nma M Jiya
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Maryam Amodu-Sanni
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Yahaya Mohammed
- Department of Medical Microbiology and Parasitology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Dada M Aquib
- Department of Radiology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Lukman K Coker
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
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Nashi N, Pandya G. Images of the month 5: Emphysematous pyelonephritis: not your garden-variety pyelonephritis. Clin Med (Lond) 2020; 19:421-422. [PMID: 31530697 DOI: 10.7861/clinmed.2019-0238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Norshima Nashi
- Division of Advanced Internal Medicine, National University Hospital, Singapore
| | - Garvi Pandya
- Division of Advanced Internal Medicine, National University Hospital, Singapore
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Takahashi K, Malinzak LE, Safwan M, Kim DY, Patel AK, Denny JE. Emphysematous pyelonephritis in renal allograft related to antibody-mediated rejection: A case report and literature review. Transpl Infect Dis 2018; 21:e13026. [PMID: 30414224 DOI: 10.1111/tid.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/01/2018] [Accepted: 10/28/2018] [Indexed: 11/27/2022]
Abstract
Emphysematous pyelonephritis (EPN) is a rare condition which can rapidly progress to sepsis and multiple organ failure with high mortality. We experienced a rare case of EPN in a renal allograft related to antibody-mediated rejection (AMR). The patient received a deceased donor kidney transplant due to end-stage renal disease secondary to diabetes mellitus. Cross-match test was negative but she had remote history of anti-HLA-A2 antibody corresponding with the donor HLA. Surgery concluded without any major events. Anti-thymoglobulin was given perioperatively for induction. She was compliant with her immunosuppressive medications making urine of 2 L/d with serum creatinine of 1.9 mg/dL at discharge on post-operative day (POD) 6. She did well until POD 14 when she presented to the clinic with features of sepsis, pain over the transplanted kidney area and decline in urine volume with elevated serum creatinine. CT revealed extensive gas throughout the transplanted kidney. Renal scan revealed non-functional transplant kidney with no arterial flow. Based on these findings, a decision to perform transplant nephrectomy was made. At laparotomy, the kidney was completely necrotic. Pathology showed non-viable kidney parenchyma with the tubules lacking neutrophilic casts suggestive of ischemic necrosis. Donor-specific antibody (DSA) returned positive with high intensity anti-HLA-A2 antibody. This is the first case of early EPN in allograft considered to have occurred as a result of thrombotic ischemia secondary to AMR. This case suggests consideration of perioperative anti-B-cell and/or anti-plasma cell therapies for historical DSA and strict post-operative follow-up in immunologically high-risk recipients to detect early signs of rejection and avoid deleterious outcomes.
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Affiliation(s)
- Kazuhiro Takahashi
- Department of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, Michigan
| | - Lauren E Malinzak
- Department of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, Michigan
| | - Mohamed Safwan
- Department of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, Michigan
| | - Dean Y Kim
- Department of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, Michigan
| | - Anita K Patel
- Department of Nephrology and Internal Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Jason E Denny
- Department of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, Michigan
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Baby N, Thoman M, Sunny B, James A, sivakumar T. Case report on emphysematous pyelonephritis with diabetic ketoacidosis. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2018. [DOI: 10.1016/j.jecr.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Karthikeyan VS, Manohar CMS, Mallya A, Keshavamurthy R, Kamath AJ. Clinical profile and successful outcomes of conservative and minimally invasive treatment of emphysematous pyelonephritis. Cent European J Urol 2018; 71:228-233. [PMID: 30038815 PMCID: PMC6051364 DOI: 10.5173/ceju.2018.1639] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 04/01/2018] [Accepted: 04/12/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Emphysematous pyelonephritis (EPN) is a rare clinical entity, characterized by gas in the renal system, due to an acute, fulminant and potentially fatal necrotizing process with varying clinical presentations. It is much more aggressive than uncomplicated pyelonephritis, with the mortality of 20-40% in the contemporary meta-analysis. MATERIAL AND METHODS A retrospective record review of inpatients at the Institute of Nephro Urology, Bangalore, India (2007-2014), who were treated after EPN was diagnosed with the aid of a CT (computed tomography) scan. RESULTS Sixty-six patients (M:F 27:39) treated for EPN over the past seven years with the mean (±SD) age of 52.32 (±12.48) years were analyzed. Median (interquartile range) duration of hospital stay was 8 (11.25) days with 4 (6%) patients requiring intensive care unit admission (median, IQR = 5.5, 1.5 days) of whom two passed away due to septicemia. Fifty-six (84.85%) patients were diabetics, forty (60.6%) patients had estimated glomerular filtration rate (eGFR) <60 ml/min/1.7 3 m2, 6 (9.1%) patients had eGFR <30 ml/min/1.73 m2 including 3 (4.5%) with eGFR <15 ml/min/1.73 m2 requiring hemodialysis and twenty-two (33%) had thrombocytopenia. Fifty (75.76%) patients were classified as Huang and Tseng Class 2, 7 (10%) as Class 3 with perinephric abscess requiring open drainage and 9 (13.64%) had bilateral EPN (Class 4). Majority (43; 65%) responded to piperacillin-tazobactam treatment. Double J stenting was done in 17 (25.76%) patients, percutaneous drainage in 5 (7.58%) patients and nephrectomy in 2 (3%) patients. CONCLUSIONS Although EPN historically carries high morbidity and mortality, modern day medical management with timely intervention in the form of urinary drainage is effective and curative in most patients resulting in a low mortality rate.
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Affiliation(s)
| | | | - Ashwin Mallya
- Department of Urology, Insititute of Nephro Urology, Bangalore, India
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Alsharif M, Mohammedkhalil A, Alsaywid B, Alhazmy A, Lamy S. Emphysematous pyelonephritis: Is nephrectomy warranted? Urol Ann 2015; 7:494-8. [PMID: 26692672 PMCID: PMC4660703 DOI: 10.4103/0974-7796.158503] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Emphysematous pyelonephritis (EPN) is associated with high mortality rate, up to 25%. There is still conflicting reports regarding the most appropriate management, conservative versus nephrectomy. OBJECTIVE To describe the outcome of patients with EPN. METHODS We retrospectively reviewed the medical records of patients diagnosed with EPN by computed tomography from three tertiary institutes in Jeddah, Saudi Arabia. Type of management was classified as conservative and surgical. The conservative includes medical and minimally invasive procedures, such as percutaneous drainage and nephrostomy. The surgical which is nephrectomy. The outcome observed was preservation of the kidney function or patient's life. RESULTS A total of 10 patients were included (9 females and 1 male), median age was 55 years and 63% were diabetic. The most common presentation was flank pain (100%), fever (75%), and vomiting (63%). The most common organism isolated was Escherichia coli. Nephrectomy was not associated with increased survival rate, while conservative management was associated with a good outcome, less morbidity (not dialysis-dependent). CONCLUSION Nephrectomy was not associated with high survival rate. Patients managed conservatively had a better overall performance and better survival. This study will add to other studies, which are encouraging conservative management.
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Affiliation(s)
- Mada Alsharif
- Research Promotion and Education Section, King Abdullah International Research Center, Jeddah, Saudi Arabia
| | - Abdullah Mohammedkhalil
- Research Promotion and Education Section, King Abdullah International Research Center, Jeddah, Saudi Arabia
| | - Basim Alsaywid
- Research Promotion and Education Section, King Abdullah International Research Center, Jeddah, Saudi Arabia ; Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Saudi Arabia ; Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ali Alhazmy
- Department of Urology, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Salahadin Lamy
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Saudi Arabia ; Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, Jeddah, Saudi Arabia
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Arsene C, Saste A, Arul S, Mestrovich J, Kammo R, Elbashir M, Berger G. A case series of emphysematous pyelonephritis. Case Rep Med 2014; 2014:587926. [PMID: 24812561 PMCID: PMC4000642 DOI: 10.1155/2014/587926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/15/2014] [Accepted: 03/15/2014] [Indexed: 12/18/2022] Open
Abstract
Introduction. Emphysematous pyelonephritis (EPN) is an uncommon infection characterized by gas in the renal parenchyma and surrounding tissues. It is rapidly progressive, requiring appropriate therapy to salvage the infected kidney. Case Description. The case series presents 5 patients with a clinical and radiologic diagnosis of EPN. Each patient had a unique predisposing factor for developing EPN. Early goal directed therapy with intravenous fluids and antibiotics was given. This was followed by less invasive urologic interventions in an attempt to avoid nephrectomy and thereby salvage the infected kidney. All five patients were discharged in clinically stable conditions. Discussion and Conclusion. This case series provides added practice based support to available literature for managing EPN. Early goal directed medical therapy for sepsis coupled with interventional urologic procedures is a valuable alternative to circumvent an upfront emergent nephrectomy, except in cases where a fulminant infection may be present at the time of admission or develop later on in the course of the patients illness despite conservative line of therapy. It also highlights the importance of considering a diagnosis of EPN in patients with urinary infections, who have certain common predisposing factors listed in our case series.
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Affiliation(s)
- Camelia Arsene
- Department of Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State School of Medicine, 4th Floor, 6071 West Outer Drive, Detroit, MI 48235, USA
| | - Abhijit Saste
- Department of Emergency Medicine, Detroit Receiving Hospital/Detroit Medical Center, 4201 Street Antoine, Suite 3R, Detroit, MI 48201, USA
| | - Shankar Arul
- Department of Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State School of Medicine, 4th Floor, 6071 West Outer Drive, Detroit, MI 48235, USA
| | - Janee Mestrovich
- Department of Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State School of Medicine, 4th Floor, 6071 West Outer Drive, Detroit, MI 48235, USA
| | - Revark Kammo
- Department of Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State School of Medicine, 4th Floor, 6071 West Outer Drive, Detroit, MI 48235, USA
| | - Mohammed Elbashir
- Department of Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State School of Medicine, 4th Floor, 6071 West Outer Drive, Detroit, MI 48235, USA
| | - Gregory Berger
- Department of Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State School of Medicine, 4th Floor, 6071 West Outer Drive, Detroit, MI 48235, USA
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Emphysematous pyelonephritis – case report and literature review. Pathology 2013. [DOI: 10.1097/01.pat.0000426899.84510.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Risk factors of renal failure and severe complications in patients with emphysematous pyelonephritis-a single-center 15-year experience. Am J Med Sci 2012; 343:186-91. [PMID: 21804369 DOI: 10.1097/maj.0b013e318225b891] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Emphysematous pyelonephritis (EPN) is a rare but severe infection of renal parenchyma. Risk factors of renal failure in patients survived from EPN are not clear. METHODS The authors retrospectively reviewed the patients with a diagnosis of EPN at Taipei Veterans General Hospital from January 1, 1995, to December 31, 2009. The authors analyzed the demographic, characteristics and the treatment modalities of those patients. The renal function of survivors after EPN episode had been followed for 1 year. RESULTS A total of 23 patients with a mean age of 62.8 ± 17.1 years were enrolled. Mean hospital duration was 31.8 ± 21.6 days. Fifteen (65.2%) patients had a history of diabetes mellitus. Mean serum HbA1c level among the diabetic patients was 11.7 ± 3.3. More than half of patients had Escherichia coli in culture. Eleven (47.8%) patients received antibiotic treatment alone. Twelve (52.2%) patients received the concurrent percutaneous drainage and antibiotics. The overall mortality rate was 8.6%. Shock, long hospital duration and the extensive classes of computed tomography image were correlated with poor outcome. A higher initial serum creatinine level (2.8 ± 1.4 versus 1.6 ± 0.8, P = 0.015) and receiving invasive therapy (67.7% versus 12.5%, P = 0.017) significantly contributed to chronic kidney disease in the follow-up. Shock is also an independent predictor of the poor outcome in those patients (P = 0.026). CONCLUSIONS In the current era, antibiotics alone provide a high success rate for the treatment of EPN. Invasive therapy is a predictor of development of chronic kidney disease. Initial resuscitation and antibiotic therapy are still the cornerstone and have the benefit of the preservation of renal function.
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Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab 2012; 16 Suppl 1:S27-36. [PMID: 22701840 PMCID: PMC3354930 DOI: 10.4103/2230-8210.94253] [Citation(s) in RCA: 475] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In general, infectious diseases are more frequent and/or serious in patients with diabetes mellitus, which potentially increases their morbimortality. The greater frequency of infections in diabetic patients is caused by the hyperglycemic environment that favors immune dysfunction (e.g., damage to the neutrophil function, depression of the antioxidant system, and humoral immunity), micro- and macro-angiopathies, neuropathy, decrease in the antibacterial activity of urine, gastrointestinal and urinary dysmotility, and greater number of medical interventions in these patients. The infections affect all organs and systems. Some of these problems are seen mostly in diabetic people, such as foot infections, malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis. In addition to the increased morbidity, infectious processes may be the first manifestation of diabetes mellitus or the precipitating factors for complications inherent to the disease, such as diabetic ketoacidosis and hypoglycemia. Immunization with anti-pneumococcal and influenza vaccines is recommended to reduce hospitalizations, deaths, and medical expenses.
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Affiliation(s)
- Juliana Casqueiro
- Department of Pediatrics, Pediatric Endocrinology Unit, Hospital Universitario Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Janine Casqueiro
- Department of Pediatrics, Pediatric Endocrinology Unit, Hospital Universitario Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Cresio Alves
- Department of Pediatrics, Pediatric Endocrinology Unit, Hospital Universitario Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
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Laway BA, Bhat MA, Bashir MI, Ganie MA, Mir SA, Daga RA. Conservative management of emphysematous pyelonephritis. Indian J Endocrinol Metab 2012; 16:303-305. [PMID: 22470875 PMCID: PMC3313756 DOI: 10.4103/2230-8210.93776] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Emphysematous pyelonephritis, though uncommon, is a severe necrotizing kidney infection common in patients with diabetes. Surgical treatment has been advocated as the treatment of choice in most of the patients. We present the clinical course of an elderly lady who presented with emphysematous pyelonephritis and was successfully managed with medical treatment despite the presence of adverse prognostic factors like acute renal failure and thrombocytopenia.
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Affiliation(s)
- Bashir Ahmad Laway
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Manzoor Ahmad Bhat
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Mir Iftikhar Bashir
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Mohd Ashraf Ganie
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Shahnaz Ahmad Mir
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Riyaz Ahmad Daga
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
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