Background: Bilateral emphysematous pyelonephritis is a life threatening condition usually occurring in diabetics. Management of this condition has traditionally been aggressive and surgery is considered mandatory. However, this is itself a hazardous intervention in a septic, unstable patient with circulatory or liver failure. When bilateral disease is present, the need for long-term dialysis is obviously unavoidable.

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Several epidemiological studies have associated the presence of hepatitis C virus (HCV) with the development of B-cell malignant lymphoma. However, in areas where the prevalence of HCV is low, this association has not been demonstrated. The aim of this study was to established the prevalence of HCV in patients with B-cell malignant lymphoma. The study was performed in 416 patients with new, previously untreated B-cell malignant lymphoma (236 diffuse large cell [DLC], 97 follicular lymphoma, and 83 marginal B-cell zone malignant lymphoma) and 1902 cases (682 first-degree relatives, 832 healthy blood donors, and 408 patients with solid tumors); furthermore, 353 patients with chronic liver disease associated to HCV were the control groups. We found a prevalence of 0.48 positive HCV among malignant lymphoma, 0.12 for healthy blood donors, 0 in first-degree relatives, and 0.56 in patients with solid tumors, that were statistically significant. The odds ratio was 1.86 and its confidence interval included the equality. None of the patients with chronic liver disease and HCV developed malignant lymphoma in a median follow-up of 7.9 yr. We felt that the presence of HCV is not significant in the development of malignant lymphoma, and that reports of high prevalence were associated also to a high prevalence of HCV in the general population and this association will be considered hazardous.

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