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[Emphysematous pyelonephritis. Two cases].

Lotfi Cherif1, Karima Khiari, Néjib Ben Abdallah

  • 1Service de néphrologie et de médecine interne, hôpital Charles-Nicolle, boulevard 9-Avril, 1006 Tunis, Tunisie. hedi.benmaiz@rns.tn

Nephrologie & Therapeutique
|August 10, 2006
PubMed
Summary

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Emphysematous pyelonephritis, a severe kidney infection with gas, requires consideration in diabetic women with severe pyelonephritis. Prompt diagnosis and treatment, medical or surgical, lead to favorable outcomes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Emphysematous pyelonephritis (EPN) is a rare, severe necrotizing renal infection.
  • Characterized by gas within the renal parenchyma and surrounding tissues.
  • Often associated with uncontrolled diabetes mellitus.

Observation:

  • Two cases of EPN in diabetic women (53 and 50 years old) are presented.
  • Case 1: Nephrectomy due to septic shock, acute renal failure, hematuria, and thrombocytopenia.
  • Case 2: Successful medical management.

Findings:

  • Both patients experienced favorable outcomes.
  • EPN diagnosis should be considered in diabetic women with severe acute pyelonephritis resistant to medical treatment.
  • Risk factors like septic shock, renal failure, hematuria, and thrombocytopenia may necessitate aggressive management.

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Implications:

  • Highlights the importance of early recognition of EPN in high-risk patients.
  • Emphasizes the need for tailored treatment strategies based on clinical presentation and risk factors.
  • Suggests a critical role for prompt medical and/or surgical intervention in managing this severe condition.