Emphysematous pyelonephritis: Two cases with successful management
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Keywords

Pyelonephritis
urinary tract infection
diabetes mellitus
Escherichia
coli
hyperglycemia

How to Cite

1.
Mondol Almeida ZM, Martínez Ávila MC, González Macea OJ, Almanza Hurtado AJ, Blanquicett Diaz A de J, Vásquez Ucros HE. Emphysematous pyelonephritis: Two cases with successful management: Pielonefritis enfisematosa: reporte de dos casos con manejo exitoso. Rev. Colomb. Nefrol. [Internet]. 2020 Nov. 20 [cited 2024 Mar. 29];8(1):e418. Available from: https://revistanefrologia.org/index.php/rcn/article/view/418

Abstract

Emphysematous pyelonephritis is a serious disease with an infrequent presentation and high mortality. It tends to occur more frequently in the population with risk factors, among which the following stand out: type 2 diabetes mellitus, obstructive uropathy, alcoholism, immunosuppression. The radiological classification of emphysematous pyelonephritis ranges from type one, which comprises gas that involves the collecting system, to type 4, which is a single or bilateral kidney disease.

Treatment will depend on the degree of severity, milder cases can be treated with catheter or percutaneous drainage plus antibiotic therapy, while more severe cases may require paranephrectomy surgery. Patients with septic shock, thrombocytopenia, acute renal failure, and hypoalbuminemia generally have a poor prognosis.

We present two poorly controlled diabetic patients over 50 years of age diagnosed through computed tomography. One of the patients with obstructive uropathy and the other with horseshoe kidney, both patients successfully treated with medical management and minimally invasive procedure.

https://doi.org/10.22265/acnef.8.1.418
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References

Falagas ME, Alexiou VG, Giannopoulou KP, Siempos II. Risk factors for mortality in patients with emphysematous pyelonephritis: a meta- analysis. J Urol 2007;178(3 Pt 1):880-5 https://doi.org/10.1016/j.juro.2007.05.017

Huang JJ, Tseng CC. Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis and pathogenesis. Arch Intern Med 2000;160:797-805. https://doi.org/10.1001/archinte.160.6.797

Kangjam SS, Irom KS, Khumallambam IS, Sinam RS. Role of conservative management in emphysematous pyelonephritis: A retrospective study. J Clin Diagn Res 2015; 9(11): PC09?11. https://doi.org/10.7860/JCDR/2015/16763.6795

Gállego-Sales, S., Jamaica-Verduzco, E., González-Rangel, G., & López-Retamosa, A. K. Pielonefritis enfisematosa bilateral; presentación de un caso tratado exitosamente con procedimiento mínimamente invasivo. Rev Mex Urol 2010; 70(5), 315-318.

?elic D, Božci D, Petrovi K, Živojinov S, Djurdjevic-Mirkovic T, Popovic M. Emphysema-tous pyelonephritis – case report and review of literature. Vojnosanit Pregl. 2017;74(12):312.https://dx.doi.org/10.2298/VSP160328312C

Somani BK, Nabi G, Thorpe P, Hussey J, Cook J, N'Dow J, ABA- CUS Research Group. Is percutaneous drainage the new gold standard in the management of emphysematous pyelonephritis? Evidence from a systematic review. J Urol. 2008;179:1844-9. https://doi.org/10.1016/j.juro.2008.01.019

Duggal A, Koury G, Waraich KK. Medical therapy in emphysematous pyelonephritis. In-fect Dis Clin Pract. 2011; 19(2):124-5. https://dx.doi.org/10.1097/IPC.0b013e3181e9b805

Piedra Valoy I, Medina Holguín JL, Varela Pinedo L, Zegarra Montes L, Melgarejo Zevallos W, Medina Ninaconcor R, et al. Pielonefritis enfisematosa: reporte de dos casos y revisión de la literatura. Rev Med Hered. 2007;18:212-7. https://doi.org/10.20453/rmh.v18i4.892

Derouiche A, El Attat R, Hentati H, Blah M, Slama A, Chebil M. Emphysematous pyelitis: epidemiological, therapeutic and evolutive features.Tunis Med2009;87(3):180-183.

Ríos QM, Pamo RO, Alvarado LA, Cumpa QR, Cruzado GC. Pielonefritis enfisematosa. Rev Soc Peru Med Interna 2012;25:140-145.

Blanco DA, Barbagelata LA, Fernández RE, Casas MR y col. Pielonefritis enfisematosa. Presentación de un caso y revisión de la literatura. Actas Urol Esp 2003;27:721-725 https://doi.org/10.1016/S0210-4806(03)73003-4

Aguilar-García CR, Naranjo-Tadeo I. Pielonefritis enfisematosa. Med Int Méx 2014;30:215-220.

Mokabberi R, Ravakhan K. Emphysematous urinary tract infections: diagnosis, treatment and survival (case review series). Am J Med Sci 2007;33:111-116. https://doi.org/10.1097/00000441-200702000-00009

Nayeemuddin M, Wiseman O. Emphysematous pyelonephritis. NatureClinical PracticeUrology. 2005;2(2):108-12.

Bhat RA, Bashir G, Wani M, Lone S. Emphysematous pyelonephritis caused by Candidaparapsilosis: an unknown etiological agent. N Am J Med Sci. 2012;4(8):364-6. https://dx.doi.org/10.4103/1947-2714.99521

KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of ChronicKidney Disease. Kidney International Supplements. 2013;3(1).

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