Case Report of an Atypical Abdominal Pain Found to be a Rare Corynebacterium Emphysematous Pyelitis
Manpreet Singh1, Obed Barrera Adame1, Mehrdad Alaie1
1Emergency Department, St. Barnabas Hospital (SBH) Health System, Bronx, USA.
Abstract:
Recognizing life-threatening infections is crucial for an emergency physician. In this case report, we describe an atypical presentation of a severe, infiltrating kidney infection, which, if not recognized early, could have led to a detrimental outcome. Emphysematous pyelitis, which is class I of emphysematous pyelonephritis, is a rare entity, and patients may present with a urinary tract infection or pyelonephritis. To add to this, underrecognition of gram-positive organisms, in this case Corynebacterium, can delay treatment and worsen outcomes, as described in this case. Through this case, we wish to create awareness of this disease and to reinforce emergency physicians to keep this entity on their differential diagnosis when evaluating an immunocompromised patient.
Insights
Emphysematous pyelitis, a rare kidney infection, can present atypically. Early recognition of this severe infection, even with gram-positive Corynebacterium, is vital for emergency physicians to prevent poor outcomes in immunocompromised patients.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Nephrology
Background:
- Life-threatening infections require prompt recognition by emergency physicians.
- Emphysematous pyelitis, a rare form of emphysematous pyelonephritis (Class I), can mimic typical urinary tract infections or pyelonephritis.
- Immunocompromised patients are at increased risk for severe infections.
Observation:
- This case report details an atypical presentation of severe, infiltrating emphysematous pyelitis.
- The causative organism was identified as a gram-positive bacterium, Corynebacterium.
- Delayed diagnosis was attributed to the unusual presentation and underrecognition of the specific pathogen.
Findings:
- Emphysematous pyelitis, though rare, must be considered in the differential diagnosis of kidney infections, particularly in immunocompromised individuals.
- Gram-positive organisms like Corynebacterium can cause severe pyelonephritis and may be overlooked.
- Atypical presentations can delay the diagnosis and treatment of severe kidney infections.
Implications:
- Increased awareness among emergency physicians regarding emphysematous pyelitis and its atypical presentations is crucial.
- Prompt and accurate diagnosis of emphysematous pyelitis can prevent severe complications and improve patient outcomes.
- Consideration of a broader range of pathogens, including gram-positive bacteria, is essential in managing kidney infections in immunocompromised patients.
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