Document Detail

Emphysematous pyelonephritis. Case report
MedLine Citation:
PMID:  19736372     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe an unusual case of emphysematous pyelonephritis, a disease with high morbidity and mortality. METHODS: We present the case of a 62-year old diabetic female with history of kidney stones, who consulted for fever, left lower-back pain and impairment of the general condition. Abdominopelvic computed tomography revealed a perinephric collection of air reaching the abdominal wall. RESULTS: After initial medical management with antibiotics and general supportive measures, we performed an open incision and drainage. A week later, signs of sepsis reappeared and the left kidney was excised. The patient died two weeks later of septic shock. CONCLUSIONS: This disease must be suspected in diabetic females with renal lithiasis and pyelonephritis not responding to treatment, and impaired general condition. Early diagnosis (computed tomography is the gold-standard) and supportive measures are essential for initial management. Surgery can be open (drainage, initial or deferred nephrectomy), percutaneous (nephrostomy) or endoscopic (double-J stent). Conservative management is a choice in bilateral or mild cases. Mortality rate is high and worsens with delayed therapy.
Tristán Dellavedova; María Laura Racca; Rolando Ponzano; Juan Pablo Sarría; Federico Minuzzi; Gustavo Minuzzi
Publication Detail:
Type:  Case Reports; English Abstract; Journal Article    
Journal Detail:
Title:  Archivos españoles de urología     Volume:  62     ISSN:  0004-0614     ISO Abbreviation:  Arch. Esp. Urol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-09-08     Completed Date:  2009-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0064757     Medline TA:  Arch Esp Urol     Country:  Spain    
Other Details:
Languages:  spa     Pagination:  406-9     Citation Subset:  IM    
FUCDIM (Fundación Urológica Córdoba para la Docencia e Investigación Médica), Cordoba, Argentina.
Vernacular Title:
Pielonefritis enfisematosa. Comunicación de un caso.
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MeSH Terms
Emphysema* / complications,  diagnosis,  therapy
Middle Aged
Pyelonephritis* / complications,  diagnosis,  therapy

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