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Bilateral emphysematous pyelonephritis caused by Candida infection
T S Hildebrand1, L Nibbe, U Frei
1Campus Virchow-Klinikum, Humboldt-University of Berlin, Berlin, Germany. thildeb@ukrv.de
Summary
Emphysematous pyelonephritis, a severe kidney infection, typically requires surgery. This case highlights successful conservative treatment of a fungal infection in a diabetic patient, preserving renal function.
Area of Science:
- Nephrology
- Infectious Diseases
- Mycology
Background:
- Emphysematous pyelonephritis (EPN) is a rare, severe necrotizing renal infection.
- It is predominantly caused by bacterial pathogens, often necessitating urgent surgical management.
- Diabetes mellitus is a significant risk factor for EPN.
Observation:
- A diabetic patient presented with bilateral EPN.
- The causative organism identified was Candida, a fungal pathogen.
- The patient was managed conservatively with antifungal medication.
Findings:
- Despite the potential nephrotoxicity of the antifungal drug, renal function recovered significantly.
- Conservative management was successful in this case of fungal EPN.
- This contrasts with the typical surgical approach for bacterial EPN.
Implications:
- Fungal EPN may be amenable to conservative treatment, even in severe cases.
- This case expands the understanding of EPN management beyond surgical intervention.
- Preservation of renal function is achievable with appropriate antifungal therapy.