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[Emphysematous pyelonephritis: report of a case]
Hinyokika Kiyo. Acta Urologica Japonica
|February 1, 1985
Summary
Emphysematous pyelonephritis, a severe kidney infection with gas formation, can be successfully treated conservatively. This case highlights effective management with antibiotics and supportive care, leading to recovery.
Area of Science:
- Nephrology
- Infectious Diseases
- Radiology
Background:
- Emphysematous pyelonephritis is a rare, aggressive necrotizing infection of the renal pelvis and parenchyma.
- Diabetes mellitus is a significant risk factor, often associated with this condition.
Observation:
- A 54-year-old female with diabetes presented with bilateral ureteral stones.
- Post-ureterolithotomy, she developed symptoms suggestive of pyelonephritis.
- Abdominal X-rays (KUB) revealed a left renal gas shadow; pyelography and CT confirmed gas within the renal parenchyma and pyelocalyceal system.
Findings:
- Conservative management including intensive antibiotics, IV fluids, and glycemic control was initiated.
- The patient showed a decrease in left renal function initially.
- After 3 weeks of treatment, the gas shadow resolved, with recovery of renal architecture and function.
Implications:
- Conservative treatment can be effective for emphysematous pyelonephritis, even in severe cases.
- Prompt diagnosis using imaging modalities like CT is crucial.
- Management should focus on antibiotics, supportive care, and addressing underlying conditions like diabetes.