Bilateral Emphysematous Pyelonephritis with Autosomal-Dominant Polycystic Kidney Disease Successfully Treated by Conservative Method

Abstract

Emphysematous pyelonephritis (EPN) is an uncommon and potentially life-threatening necrotizing inflammation of the renal parenchyma. EPN associated with autosomal dominant polycystic kidney disease (ADPCK) is extremely rare. We report such a case of bilateral EPN with ADPCK that was successfully treated with conservative methods. To our knowledge, our case is only the second to document bilateral EPN occurring with ADPCK and the first one to be treated successfully with conservative methods.

Retrospective analysis of clinical profile prognostic factors and outcomes of 19 patients of emphysematous pyelonephritis

“…Renal replacement therapy was offered, but the patient did not give consent for it. Emphysematous pyelonephritis has rarely been reported to occur in ADPKD both in diabetics and non diabetics [20,21], and the disease has been managed conservatively with good outcomes. Our case with underlying ADPKD had unilateral involvement and responded well to conservative management.…”

Acute bilateral emphysematous pyelonephritis successfully managed by medical therapy alone: A case report and review of the literature

“…Angulo [25], Grozel [26], Shimizu [27] and Tahir [19] et.al. Each reported cases of bilateral EPN that were successfully treated with antibiotics alone, thus obviating the need for renal replacement therapy which would have been needed if they were treated with bilateral nephrectomies.…”

Bilateral emphysematous pyelonephritis in autosomal dominant polycystic kidney disease

“…Our patient is one the very few cases (six) of ADPKD with EPN to be reported so far. [2–578] Of the six cases available online (Pubmed and Google), three patients responded to conservative management,[2–4] one required open drainage of infected cysts,[5] and two[712] needed unilateral nephrectomy. To the best of our knowledge, this is the first case of ADPKD with bilateral EPN to be reported which required bilateral nephrectomy, as he did not respond to sensitive antibiotics given for an appropriate duration.…”