Emphysematous Pyelonephritis Case Series From South India

Area of Science:

• Nephrology
• Infectious Diseases
• Urology

Background:

• Emphysematous pyelonephritis (EPN) is a rare, severe necrotizing kidney infection with a mortality rate up to 25%.
• A retrospective study was conducted to analyze clinical, biochemical, and microbiological patterns of EPN.

Purpose of the Study:

• To observe clinical, biochemical, and microbiological patterns of EPN.
• To identify risk factors and outcomes for patients with EPN requiring hemodialysis.
• To determine prognostic variables predicting morbidity and mortality.

Main Methods:

• Retrospective analysis of clinical and laboratory data, imaging, and microbiological patterns of 51 EPN patients.
• Data analysis focused on identifying prognostic variables and outcomes, particularly for patients needing hemodialysis.
• Primary endpoints: successful treatment and all-cause mortality; Secondary endpoints: need for hemodialysis and specific treatment.

Main Results:

• Equal incidence in both sexes, median age 59 years; common symptoms include abdominal pain, fever, dysuria.
• Diabetes was present in 98.03% of patients; *Escherichia coli* was the most common organism (37.2%).
• Antibiotic treatment achieved a 100% success rate, compared to 96.42% for Double J stenting; 12.5% required indefinite hemodialysis.

Conclusions:

• Early diagnosis, broad-spectrum antibiotics, and timely intervention reduce EPN mortality.
• Abdominal pain and renal angle tenderness are key clinical findings.
• *E. coli* is the predominant pathogen; prompt antibiotic use is crucial for reducing mortality.