Case of nephropulmonary fistula and literature review

Area of Science:

• Nephrology
• Pulmonology
• Infectious Diseases

Background:

• Nephropulmonary fistula is a rare but serious condition.
• Management strategies in the literature are diverse and often unsuccessful.
• This study presents a case and literature review to identify optimal care.

Observation:

• Common features include infected kidney, ipsilateral pneumonia or pleural effusion, and identical organisms in sputum and urine cultures.
• Radiological signs like renal gaseous content may be absent even on CT scans.
• Conservative management (antibiotics, stone clearance, drainage) failed in this case.

Findings:

• Nephrectomy was ultimately required for successful treatment.
• The study provides operative tips and anesthesia recommendations for nephrectomy.
• This suggests a more aggressive surgical approach may be necessary.

Implications:

• Conservative management for nephropulmonary fistula has a high failure rate.
• Nephrectomy should be considered when conservative measures are ineffective.
• Standardized surgical guidelines are needed for this rare condition.