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Bilateral emphysematous pyelitis: a rare encounter in urology
G H Tan C C K Ho1, B Bahadzor, S Praveen
1Urology Unit, Department of General Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
La Clinica Terapeutica
|September 19, 2013
Summary
Bilateral emphysematous pyelitis (EP) is a rare kidney infection. This case and review suggest it has a better prognosis than emphysematous pyelonephritis (EPN) and can be treated with antibiotics and drainage.
Area of Science:
- Nephrology
- Infectious Diseases
- Urology
Background:
- Gas-forming infections of the kidneys include emphysematous pyelonephritis (EPN) affecting the parenchyma and emphysematous pyelitis (EP) affecting the collecting system.
- While bilateral EPN is well-documented, bilateral EP remains poorly understood, with limited case reports in the literature.
Observation:
- A rare case of bilateral EP in a 66-year-old woman with bilateral staghorn calculi and severe sepsis is presented.
- The patient was successfully treated with antibiotics and bilateral double-J stents for upper urinary tract drainage, leading to recovery after intensive care.
Findings:
- Literature search revealed only a few reports of bilateral EP, indicating its rarity.
- Compared to bilateral EPN, bilateral EP appears to follow a more benign clinical course.
- Computed tomography (CT) scans are crucial for prompt diagnosis of bilateral EP.
Implications:
- Timely antibiotic therapy is effective in treating bilateral EP.
- Drainage of the collecting system, via percutaneous methods or double-J stents, can aid recovery.
- Prompt diagnosis and management are key for favorable outcomes in bilateral EP.
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