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Emphysematous pyelonephritis responding to medical therapy
J Punnose1, T M Yahya, J S Premchandran
1Department of Internal Medicine, Al Ain Hospital, United Arab Emirates.
International Journal of Clinical Practice
|April 16, 1998
Summary
Two type 2 diabetic patients with unilateral emphysematous pyelonephritis and Escherichia coli infection recovered with antibiotics alone. Early diagnosis via imaging and prompt treatment led to good kidney function recovery.
Area of Science:
- Nephrology
- Infectious Diseases
- Diabetology
Background:
- Emphysematous pyelonephritis is a severe necrotizing infection of the kidney.
- Type 2 diabetes is a significant risk factor for urinary tract infections and their complications.
- Unilateral presentation is less common but requires specific diagnostic and management considerations.
Observation:
- Two patients with type 2 diabetes presented with unilateral emphysematous pyelonephritis.
- Gas in the renal parenchyma was detected early using ultrasound and computed tomography (CT) scans.
- Escherichia coli was the causative pathogen identified in both cases.
Findings:
- Both patients demonstrated a positive response to medical management, specifically broad-spectrum antibiotics, without surgical intervention.
- Isotope renography confirmed good functional recovery of the affected kidneys post-treatment.
- Early and accurate diagnosis facilitated effective treatment and preserved renal function.
Implications:
- Medical management alone can be effective for select cases of unilateral emphysematous pyelonephritis in diabetic patients.
- Aggressive antibiotic therapy guided by early imaging is crucial for favorable outcomes.
- This case series highlights the importance of considering non-surgical approaches in managing this severe kidney infection.