Emphysematous pyelonephritis: Our experience in managing these cases

Authors

  • Fatih Uruc Fatih Sultan Mehmet Research and Training Hospital, Istanbul
  • Ozgur Haki Yuksel Fatih Sultan Mehmet Research and Training Hospital
  • Aytac Sahin Fatih Sultan Mehmet Research and Training Hospital, Istanbul
  • ahmet urkmez Fatih Sultan Mehmet Research and Training Hospital, Istanbul
  • Caglar Yildirim Fatih Sultan Mehmet Research and Training Hospital, Istanbul
  • Ayhan Verit Fatih Sultan Mehmet Research and Training Hospital, Istanbul

DOI:

https://doi.org/10.5489/cuaj.2828

Keywords:

emphysematous pyelonephritis, medical treatment, percutaneous nephrostomy, nephrectomy

Abstract

Introduction: Emphysematous pyelonephritis (EPN) is a rare acute necrotising infection of renal parenchyma. We discuss clinical details and treatment strategies of 8 patients with EPN followed at our clinic.

Methods: We retrospectively reviewed the clinical, laboratory, radiological findings and treatment modalities of 8 patients with EPN followed at our urology clinic between 2012 and 2015.

Results: The mean patient age (female: 5; male: 3) was 62 (range: 51–82) years. Based on computed tomographic findings, EPN was classified as class 1 (n = 3), class 2 (n = 3) and class 3a (n = 2). All patients had fever, flank pain, nausea, and vomiting. Five patients had type 2 diabetes mellitus and 3 diabetic patients also had renal stones. Escherichia coli (n = 6), Klebsiella species (n = 1), and Proteus species (n = 1) were grown in urine cultures. All patients had unilateral involvement. Increased white blood cell counts, sedimentation rate, and C-reactive protein levels were detected in all cases. In addition to medical treatment, 2 patients underwent a nephrostomy catheter placement and another 2 patients underwent nephrectomy upon deterioration of her general health state. After achieving clinical stabilization with medical treatment, 1 patient underwent endoscopic ureteral stone treatment. The remaining 3 cases were treated only with antibiotherapy. All patients were discharged with clinical cure.

Conclusion: Mortality rates of EPN are gradually decreasing. Preservation of renal reserve is possible due to early diagnosis, appropriate antibiotherapy, and drainage.

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Published

2015-07-17

How to Cite

Uruc, F., Yuksel, O. H., Sahin, A., urkmez, ahmet, Yildirim, C., & Verit, A. (2015). Emphysematous pyelonephritis: Our experience in managing these cases. Canadian Urological Association Journal, 9(7-8), E480–3. https://doi.org/10.5489/cuaj.2828

Issue

Vol. 9 No. 7-8 (2015): CUAJ July

Section

Case Series

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