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Emphysematous pyelonephritis

J T Bonoan1, S Mehra, B A Cunha

  • 1Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA.

Heart & Lung : the Journal of Critical Care
|February 12, 1998
PubMed
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Emphysematous pyelonephritis is a rare but deadly kidney infection often seen in diabetics. This case highlights diagnosis via CT scan and treatment with nephrectomy and antibiotics for Escherichia coli.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the kidney.
  • It is uncommon but potentially fatal, often associated with diabetes mellitus.
  • Prompt diagnosis and management are crucial for patient outcomes.

Observation:

  • A 75-year-old female patient with diabetes presented with symptoms of pyelonephritis.
  • Computed tomography (CT) scan revealed gas within the renal parenchyma.
  • These findings led to the diagnosis of EPN.

Findings:

  • The patient underwent a total nephrectomy.
  • Antibiotic treatment was administered.
  • Blood and operative cultures identified Escherichia coli as the causative pathogen.

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Implications:

  • This case underscores the importance of considering EPN in diabetic patients presenting with pyelonephritis.
  • CT imaging is vital for diagnosing gas in the renal parenchyma, characteristic of EPN.
  • Effective management involves surgical intervention (nephrectomy) and targeted antibiotic therapy.