Emphysematous pyelonephritis: Case report and literature overview

Area of Science:

• Nephrology
• Infectious Diseases
• Surgical Oncology

Background:

• Emphysematous pyelonephritis is a rare, necrotizing kidney infection with a high mortality rate, especially in debilitated patients.
• Computed tomography (CT) is crucial for early diagnosis of this severe condition.
• Treatment traditionally involves drainage and intensive care, with nephrectomy reserved for severe cases.

Observation:

• A 73-year-old woman presented with fulminant urosepsis and multiorgan failure.
• CT revealed extensive abscess formation and free air, confirming emphysematous pyelonephritis.
• Immediate nephrectomy was performed due to the patient's critical condition.

Findings:

• The patient experienced a successful postoperative recovery with stabilization of kidney and liver function.
• Aggressive and immediate therapy, including radical nephrectomy, is vital for severe emphysematous pyelonephritis.
• Early diagnosis via advanced imaging techniques reduces mortality for renal abscesses and related infections.

Implications:

• Radical nephrectomy is a viable and potentially optimal therapeutic option for severe emphysematous pyelonephritis with urosepsis.
• Prompt surgical intervention in high-risk patients can lead to favorable outcomes.
• This case highlights the importance of aggressive management in life-threatening infections.