Ahlert K, Hecking E, Schüller J. [Bilateral emphysematous pyelonephritis, a rare cause of acute renal failure].
MEDIZINISCHE KLINIK (MUNICH, GERMANY : 1983) 1999;
94:695-8. [PMID:
10641513 DOI:
10.1007/bf03044761]
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Abstract
BACKGROUND
The emphysematous pyelonephritis is a life-threatening complication of a bacterial interstitial nephritis, and it occurs mainly in diabetics. The infection with optional anaerobic microorganisms, which are able to produce gas, is supported by a reduced state of resistance, a high glucose level in the tissue in diabetic derailment and ischemia in the infected organ, for example by a kidney infarction or by an obstructive uropathy. Mostly the inflammation occurs unilateral, only in 10% of all cases both kidneys are affected. Computer tomography allows a fast diagnosis by demonstrating gas accumulation in the kidney. Surgical measures and antibiotic therapy are the principal therapeutic methods.
CASE REPORT
The example of a 55-year-old diabetic man with bilateral emphysematous pyelonephritis demonstrates the diagnostic and therapeutic possibilities. After a fast diagnostic procedure, immediate hemodialysis in uremia and bilateral nephrectomy let the patient survive in a stable clinical condition dependent on regular dialysis treatment.
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