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Emphysematous pyelonephritis- conversion of type i to type II appearance on serial CT studies
S Komura1, N Shindoh, O Minowa
1Department of Radiology, Juntendo University Urayasu Hospital, Chiba, Urayasu, Japan.
Clinical Imaging
|July 19, 2000
Summary
Emphysematous pyelonephritis (EPN) can change subtypes during treatment. Some patients initially classified as type I EPN may progress to type II EPN, indicating a dynamic disease process.
Area of Science:
- Nephrology
- Radiology
- Infectious Diseases
Background:
- Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the kidney.
- EPN is currently classified into two subtypes based on computed tomography (CT) findings.
Observation:
- A case of EPN was observed where CT findings evolved during conservative management.
- The patient's initial CT scan showed type I EPN, characterized by renal parenchymal destruction and air density without fluid.
Findings:
- The patient's condition progressed, and subsequent CT scans revealed a change from type I to type II EPN.
- Type II EPN is characterized by the presence of significant fluid collection alongside air density.
Implications:
- This observation suggests that the classification of EPN may not be static.
- Type I EPN might transform into type II EPN under conservative treatment, necessitating careful monitoring.
- Further research is needed to understand the mechanisms and clinical significance of this subtype transformation in EPN.