EMPHYSEMATOUS PYELONEPHRITIS: A REVIEW OF SIX CASES

Authors

  • Sohrab Naushad Ali
  • Niqad Ahmed
  • Aymon Naushad
  • Mian Naushad

Abstract

Background: Emphysematous pyelonephritis is a severe life threatening necrotising infection of the renal parenchyma. The infection most commonly occurs in the diabetic population, often associated with the organism E. coli. Emphysematous pyelonephritis differs from standard pyelonephritis by the bacterial liberation and accumulation of gas in the surrounding tissues. The condition is rarely encountered in clinical practice and since the first description by Kelly et al in 1898, approximately 200 cases have been reported in the literature. Methods: The case series examines our experience with six diagnosed cases of emphysematous pyelonephritis over a one year period. Results: All patients were female, the mean age of presentation being 53 years. Of the six patients, five were diabetics with hypertension, the one exception being a non-diabetic patient who had undergone renal exploration in the past. Computed tomography confirmed the diagnosis in all patients except one which was confirmed during renal exploration. Urine culture was positive for E. coli in two patients. Conclusion: Emphysematous pyelonephritis which used to be a rare disease is now being more readily diagnosed. The cases were diagnosed at a late stage making its conservative management not feasibleKeywords: Emphysematous pyelonephritis, renal infections, nephrectomy, renal parenchyma

References

Asma Asghar, Haroon Sabir Khan, Sohail Sabir, Shahid Mehmood Rana, Tassawar Hussain.: Bilateral emphysematous phyelonepritis. Pak Armed Forces Med J 2006;56:83–6

Cherif M, Kerkeni W, Bouzouita A, Selmi MS, Derouiche A, Ben Slama MR et al. Emphysematous pyelonepritis. Epidemiological, clinical, biological, bacteriological, radiological, therapeutic and prognostic features. Retrospective study of 30 cases. Tunis Med 2012;90(10):725–9

Strofilas A, Manouras A, Lagoudianakis EE, Kotzadimitriou A, Pappas A, Chrysikos I, et al. Emphysematous pyleonephins; a rare cause of pnemonephritis; a case report and review of literature. Cases J 2008;1:91

Mohsin N, Budruddin M, Lala S, Al-Taie S: Emphysematous pyelonephritis: a case report series of four patients with review of literature. Ren Fail 2009;31(7):597–601

Huang JJ, Tseng CC: Emphysematous pyelonephritis: clinico – radiological classification, management, prognosis and pathogenesis. Arch Intern Med 2000;160(6);797–805.

Alexander S, Varughese S, David VG, Kodgire SV, Mukha RP, Kekre NS. et al. Extensive emphysematous phyelonephritis in a renal allograft treated conservately: case report and review of literature. Transp infect Dis 2012;14(6):E150–5.

Lim SK, Park I. Bilateral Emphysematous Pyelonephritis. Korean J Intern Med 2012: 27(3):366.

Vivek V, Panda A, Devasia A: Emphysematous Pyelonephritis in a renal transplant receipt-is it possible to salvage the graft?. Ann Transplant 2012;17(3):138–41

Lakshminarayana G, Mathew A, Rajesh R, Kurien G, Unni VN et al. Bilateral emphysematous pyelonephrtis in autosomal dominant polycystic kidney disease. Indian J Nephrol 2012;22(2):136–8.

Morioka H, Yanagisawa N, Suganuma A, Imamura A, Ajisawa A. Bilateral Emphysematous pyelonephritis with splenic abscess. Intern Med 2013;52(1):147–50.

Olvera-Posada D, García-Mora A, Culebro-García C, Castillejos-Molina R, Sotomayor M, Feria-Bernal G et al. Prognostic factors in Emphysematous pyelonephritis. Actas Urol Esp 2013;37(4):228–32.

Kolla PK, Madhav D, Reddy S, Pentyala S, Kumar P, Pathapati RM. Clinical profile and outcome of conservately managed emphysematous pyelonephris. ISRN Urol 2012;2012:931982

Peter JV, Biradar V, Peake SL. Emphysematous pyelonephritis. Med J Aust 2006;184(10):533.

Sugandh shetty,Edward David kim(chief editor); Emphysematous pyelonephritis.available on http//emedicine.medscape.com/article/457306-overview.

Vollans SR, Sehjal R, Forster JA, Rogawski KM. Emphysematous pyelonephritis in type II diabetes; A case report of undiagnosed ureteric colic. Cases J 2008;1:192.

Dubey IB, Agrawal V, Jain BK. Five patients with emphysematous pyelonephritis. Iran J Kidney Dis 2011;5(3):204–6.

Ubee SS, McGlynn L, Fordham M. Emphysematous pyelonephritis. BJU Int 2010;107:1474–8.

Roy C, DPfleger D, Tuchman CM. Emphysematous pyelonephritis: Finding in five patients. Radiology 2011;28(3):647–50.

He Y, Shi B, Wu X, Hou P, Wang Y. Emphysematous pyelonephritis treated with elective nephrectomy in a 75 year old diabetic patient. Clin Pract 2012;2:e14

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Published

2014-12-01