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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
Published on: July 18, 2017
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Emphysematous pyelonephritis in a transplanted kidney
Cristiano Claudino Oliveira1, Paula Dalsoglio Garcia2, Rosa Marlene Viero1
1Department of Pathology - Botucatu School of Medicine - Universidade Estadual Paulista "Júlio de Mesquita Filho" - Botucatu/SP, Brazil .
Autopsy & Case Reports
|February 18, 2017
Summary
Emphysematous pyelonephritis is a rare kidney infection. In transplant patients, it can lead to poor outcomes, necessitating nephrectomy and highlighting the need for tailored treatment strategies.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplantation Medicine
Background:
- Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the kidney.
- EPN is exceptionally rare in kidney transplant recipients.
- Diagnosis and risk stratification typically rely on computed tomography (CT) imaging.
Observation:
- A 58-year-old kidney transplant recipient presented with sepsis secondary to a urinary tract infection.
- Abdominal CT revealed features consistent with EPN and an associated abscess.
- A graft biopsy showed no signs of infection or rejection, despite clinical deterioration.
Findings:
- The patient experienced a poor clinical course, ultimately requiring nephrectomy.
- Pathological analysis confirmed chronic pyelonephritis with necrotizing papillitis.
- The patient became hemodynamically unstable and deceased.
Implications:
- Current diagnostic and treatment criteria for EPN in non-transplant patients may not be directly applicable to kidney transplant recipients.
- Clinical status is a critical factor in deciding on nephrectomy for EPN in this vulnerable population.
- Further research is needed to establish optimal management protocols for EPN in kidney transplant patients.
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