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Emphysematous perinephric abscess without diabetes or urinary obstruction
S Pandey1, S Kumar, L N Dorairajan
1Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Urologia Internationalis
|September 27, 2003
Summary
Emphysematous pyelonephritis, a rare kidney infection, typically affects diabetic or obstructed patients. This case highlights its rare occurrence in a patient without these risk factors, emphasizing the need for broader diagnostic considerations.
Area of Science:
- Nephrology
- Infectious Diseases
- Urology
Background:
- Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the renal pelvis.
- EPN is predominantly associated with diabetes mellitus and urinary tract obstruction.
- It represents a surgical emergency with high morbidity and mortality if untreated.
Observation:
- A male patient presented with symptoms suggestive of pyelonephritis.
- Diagnostic workup revealed no evidence of diabetes mellitus or obstructive uropathy.
- The patient was diagnosed with emphysematous pyelonephritis despite the absence of typical risk factors.
Findings:
- This case represents a rare instance of EPN occurring in an immunocompetent patient without predisposing conditions.
- The successful management involved a combination of antibiotics, supportive care, and surgical drainage.
- Complete recovery was achieved, demonstrating the efficacy of prompt and multimodal treatment.
Implications:
- Highlights the importance of considering EPN even in the absence of classic risk factors like diabetes or obstruction.
- Underscores the need for a high index of suspicion in patients presenting with severe pyelonephritis.
- Suggests that prompt diagnosis and aggressive management, including surgical intervention when necessary, are crucial for favorable outcomes in rare EPN cases.