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[The association of pleural empyema and perinephritic infection: apropos 4 cases]
A Vargas Puerto1, I Alfageme Michavila, L Moreno Arrastio
1Sección de Neumologia, Hospital Universitario de Valme, Sevilla.
Abstract:
Empyema of renal origin is very rare (3% in our series). We discuss 4 cases of empyemas associated to perirenal infection. Two of them were diabetic and all of them have renal lithiasis. They made their debut through pleural effusions, isolating Escherichia coli in all of them. Treatment was antibiotics and drainage in both foci, three of them evolved to healing and one of them died being the abdominal foci without drainage. This association must be suspected when no clear etiology of the empyema is present in patients with history of renal lithiasis and diabetes.
Insights
Empyema originating from the kidney is rare, often linked to kidney stones and diabetes. Prompt diagnosis and drainage of both kidney and chest infections are crucial for successful treatment.
Area of Science:
- Nephrology
- Pulmonology
- Infectious Diseases
Background:
- Empyema, a collection of pus in the pleural space, can have various causes.
- Renal origin empyema is exceptionally rare, accounting for only 3% of cases.
Observation:
- This study reports on 4 cases of empyema associated with perirenal infections.
- Two patients had diabetes mellitus, and all presented with renal lithiasis (kidney stones).
- Escherichia coli was the isolated pathogen in all cases, presenting initially as pleural effusions.
Findings:
- Treatment involved antibiotics and drainage of both the renal and pleural infections.
- Three out of four patients recovered.
- One patient died due to untreated abdominal (renal) foci.
Implications:
- Clinicians should suspect renal origin in cases of empyema without a clear cause, especially in patients with a history of kidney stones and diabetes.
- Integrated management of renal and pleural infections is vital for improving patient outcomes.