Bilateral emphysematous pyelonephritis caused by Candida infection

Hildebrand, T; Nibbe, Lutz; Frei, Ulrich; Schindler, Ralf

doi:10.1016/s0272-6386(99)70331-8

Cited by 39 publications

(21 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many other microorganisms including Klebsiella, proteus and streptococcus can be isolated. 8 Even in rare cases, candida and anaerobic microorganisms have also been reported. 9,10 However, Clostridium has never been isolated in this type of infection, though it is a well known gas forming bacteria.…”

Section: Resultsmentioning

confidence: 99%

Emphysematous Pyelonephritis: Our Institutional Experience

B¹,

Rambabu²,

Prakash³

2015

jemds

View full text Add to dashboard Cite

Emphysematous pyelonephritis (EPN) is a rare acute necrotizing infection of renal parenchyma. We discuss clinical details and treatment strategies of 28 patients with EPN followed at our hospital. EPN is common in persons with diabetes, often has a fulminating course and can be fatal if not recognized and treated promptly. Its overall mortality rate ranges between 19% and 43%. METHODS: We retrospectively reviewed the clinical, laboratory, radiological findings and treatment modalities of 18 patients with EPN followed at our hospital between 2012 and 2014. RESULTS: The mean patient age (Female: 12; male: 6) was 65 years (Range: 51-82). Based on computed tomographic findings, EPN was classified as class I (n=3), class II (n=6), class IIIA (n=5), class IIIB (n=3) and class 1V (n=1). All patients had fever, flank pain, nausea, and vomiting. Sixteen patients had type 2 diabetes mellitus and 4 diabetic patients also had renal stones. Escherichia coli (n=14), Klebsiella species (n=3), and mixed species (n=1) were grown in urine cultures. Seventeen 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, 5 patients underwent a nephrostomy catheter placement and a total of 3 patients underwent nephrectomy upon deterioration. After achieving clinical stabilisation with medical treatment, 7 patients underwent endoscopic ureteral stone treatment. The remaining 3 cases were treated only with antibiotics. One patient died even after nephrostomy and antibiotic therapy and seventeen 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 antibiotic therapy, and drainage.

show abstract

Section: Resultsmentioning

confidence: 99%

Emphysematous Pyelonephritis: Our Institutional Experience

B¹,

Rambabu²,

Prakash³

2015

jemds

View full text Add to dashboard Cite

show abstract

“…Most frequently, Escherichia coli is identified; many other microorganisms, including klebsiella, proteus and streptococcus, can be isolated. 8 Even in rare cases, candida and anaerobic microorganisms have also been reported. 9,10 However, Clostridium has never been isolated …”

Section: Discussionmentioning

confidence: 99%

Emphysematous pyelonephritis: Our experience in managing these cases

Uruç

Yüksel

Şahin

et al. 2015

CUAJ

View full text Add to dashboard Cite

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.

show abstract

“…E. coli is the most common bacteria implicated in EPN, others are Klebsiella and proteus mirabilis. EPN caused by group D streptococcus, coagulase-negative staphylococcus and anerobic microorganisms including Clostridium septicum, Candida albicans, Criptococcus neoformans and Pneumocystis Jiraveci have, in rare cases, been reported [9,17,18]. The presence of a less common causative organism in urine or blood culture does not require that patient to be treated for EPN unless there are radiological features to suggest that EPN might be present [4].…”

Section: Discussionmentioning

confidence: 99%

Emphysematous Pyelonephritis in Two Cases at Two Different Stages: Early and Late

Demir

2014

J Med Cases

View full text Add to dashboard Cite

Emphysematous pyelonephritis (EPN) has been defined as a necrotizing infection of the renal parenchyma and its surrounding areas that result in the presence of gas in the renal parenchyma, collecting system or perinephric tissue. The final diagnosis mostly depends on the radiological findings since clinical and biochemical findings of the EPN can be different from case to case. The diseases can be seen not only in diabetic patients but also occasionally in patients without diabetes mellitus with obstruction of the the urinary system. In this article, we discussed the EPN based on two patients at the two different stages, late and early, respectively.

show abstract

Bilateral emphysematous pyelonephritis caused by Candida infection

Cited by 39 publications

References 10 publications

Emphysematous Pyelonephritis: Our Institutional Experience

Emphysematous Pyelonephritis: Our Institutional Experience

Emphysematous pyelonephritis: Our experience in managing these cases

Emphysematous Pyelonephritis in Two Cases at Two Different Stages: Early and Late

Contact Info

Product

Resources

About