Mahboubeh Mirzaei*, Mohammad Reza Ebadzadeh, Ali Kamalati and Rayka Sharifian-Amiri
Department of Urology, Kerman University of Medical Sciences, IranFulltext PDF
Emphysematous pyelonephritis is an acute necrotizing and suppurative infection of the kidney parenchyma. It is described as presence of gas within the kidney parenchyma and surrounding tissues. This rare condition is usually seen in diabetic women or immunocompromised patients. In this report, we describe four cases of emphysematous pyelonephritis, all of whom were managed by broad spectrum antibiotics and drainage. Our cases were in different clinical stages of the disease and all of them were discharged after two to three weeks without need for a major surgery to treat emphysematous pyelonephritis. Patients with kidney stone were referred to an endourologist for percutaneous nephrolithotomy after hospital discharge. We managed these four cases conservatively with aggressive medical treatment including good and rapid control of dehydration, high blood glucose level (in diabetic cases), and hypoxia, sepsis, and kidney failure. All patients had a good treatment outcome. Thus, we believe that in most patients conservative therapy can replace nephrectomy to treat emphysematous pyelonephritis.
Emphysematous pyelonephritis; Computed tomography; Percutaneous intervention
Mirzaei M, Ebadzadeh MR, Kamalati A, Sharifian-Amiri R. Our Experience in Managing Emphysematous Pyelonephritis: A Short Review of Four Cases. Ann Clin Case Rep. 2019; 4: 1616.