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[Emphysematous pyelonephritis complicated with diabetes mellitus: a case report]
Hinyokika Kiyo. Acta Urologica Japonica
|August 31, 1999
Summary
Emphysematous pyelonephritis, a severe kidney infection, often requires nephrectomy for treatment. This case highlights the effectiveness of surgical intervention when conservative measures fail in diabetic patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Urology
Background:
- Emphysematous pyelonephritis (EP) is a rare, severe necrotizing infection of the renal parenchyma.
- Diabetes mellitus is a significant risk factor, often associated with a poorer prognosis.
- Diagnosis typically involves imaging demonstrating gas within the renal parenchyma.
Observation:
- A 46-year-old female with diabetes presented with lower right abdominal pain and abnormal gas shadows on CT.
- Initial urinalysis showed no significant pyuria, complicating early diagnosis.
- The patient's condition deteriorated despite aggressive supportive therapy.
Findings:
- Right nephrectomy was performed due to the severity of the emphysematous pyelonephritis.
- Post-nephrectomy, the patient showed marked improvement in her general condition.
- A review of 122 Japanese literature cases was conducted, including the current case.
Implications:
- Nephrectomy may be a life-saving intervention for severe emphysematous pyelonephritis, particularly in diabetic patients.
- Early recognition and prompt surgical management are crucial for favorable outcomes in EP.
- Further research into the etiology, optimal treatment strategies, and prognostic factors for EP is warranted.