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Foley Follies: Emphysematous Pyelitis from Instrumentation in Obstructive Uropathy

Shimshon Wiesel1, Anna Gutman1, Jonah E Abraham2

  • 1Internal Medicine, Staten Island University Hospital, Northwell Health.

Cureus
|November 4, 2017
PubMed

Insights

Emphysematous pyelitis (EP), a severe urinary infection, can occur after urinary tract procedures. This case shows conservative management can resolve EP, emphasizing prompt diagnosis after instrumentation.

Area of Science:

  • Urology
  • Infectious Diseases
  • Medical Case Reports

Background:

  • Emphysematous pyelitis (EP) is a rare, severe necrotizing infection of the urinary tract.
  • EP is a subclass of emphysematous pyelonephritis (EPN), a life-threatening condition.
  • Urinary tract instrumentation is a potential risk factor for developing EP.

Observation:

  • An 81-year-old male patient presented with symptoms suggestive of a urinary tract infection.
  • The patient had recently undergone urinary tract instrumentation.
  • Diagnostic evaluation confirmed the presence of emphysematous pyelitis.

Findings:

  • The case of emphysematous pyelitis resolved successfully with conservative medical management.
  • No surgical intervention was required for the resolution of the infection.
  • This outcome suggests a less invasive approach may be effective in select EP cases.

Implications:

  • Urinary tract manipulation can lead to serious complications like EP.
  • Prompt diagnosis and appropriate management are crucial for favorable outcomes in EP.
  • Conservative medical management should be considered as a primary treatment option for EP.
Keywords:
acute kidney injuryemphysematous pyelitisfoley catheterhydronephrosisiatrogenic injuriesurinary tract infection

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