Emphysematous pyelonephritis: Our experience in managing these cases

Area of Science:

• Urology
• Infectious Diseases
• Nephrology

Background:

• Emphysematous pyelonephritis (EPN) is a rare, severe necrotizing infection of the kidney parenchyma.
• This study reviews clinical details and treatment strategies for EPN patients.

Purpose of the Study:

• To analyze clinical, laboratory, and radiological findings in EPN patients.
• To evaluate various treatment modalities and their outcomes for EPN.

Main Methods:

• Retrospective review of 8 EPN patients treated between 2012 and 2015.
• Analysis of computed tomography (CT) findings for EPN classification.
• Review of patient demographics, comorbidities (diabetes, renal stones), urine culture results, and inflammatory markers.

Main Results:

• The study included 8 patients (5 female, 3 male) with a mean age of 62 years.
• CT classified EPN as class 1 (3), class 2 (3), and class 3a (2).
• Common symptoms included fever, flank pain, nausea, and vomiting. Escherichia coli was the most common pathogen. Treatments ranged from antibiotherapy alone to nephrostomy, nephrectomy, and ureteral stone treatment. All patients achieved clinical cure.

Conclusions:

• Mortality rates for EPN are decreasing due to advancements in care.
• Early diagnosis, effective antibiotherapy, and timely drainage are crucial for preserving renal function and improving patient outcomes.