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Published on: July 18, 2017
Emphysematous pyelonephritis: Our experience with conservative management in 14 cases
Pramod Kumar Sharma1, Ritu Sharma, Mukesh K Vijay
1Department of Urology, Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, India.
Urology Annals
|September 20, 2013
Summary
Emphysematous pyelonephritis (EPN) is a severe kidney infection. Conservative management, including antibiotics and interventions like drainage, proved safe and effective for fourteen patients, with most recovering without nephrectomy.
Area of Science:
- Nephrology
- Infectious Diseases
- Urology
Background:
- Emphysematous pyelonephritis (EPN) is a rare, severe, necrotizing infection of the kidney.
- This study details the clinical presentation, management, and outcomes of 14 EPN patients.
Purpose of the Study:
- To present clinical details, management strategies, and outcomes of Emphysematous pyelonephritis (EPN) patients.
- To evaluate the efficacy and feasibility of conservative management for EPN.
Main Methods:
- Retrospective analysis of 14 EPN patient hospital records (August 2007 - February 2011).
- All patients received conservative management, including fluid resuscitation, glycemic control, antibiotics, and interventions as needed.
- Follow-up ranged from six months to one year.
Main Results:
- Fever was universal; flank pain and renal angle tenderness were common signs.
- Escherichia coli was the most frequent pathogen (57%).
- Conservative management was successful in all patients, with six requiring percutaneous drainage or DJ stenting. Three patients underwent delayed nephrectomy for non-functioning kidneys.
Conclusions:
- Early diagnosis facilitates conservative management of Emphysematous pyelonephritis (EPN).
- Conservative management strategies are safe, effective, and feasible for EPN.
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