Emphysematous Pyelonephritis: A 5-Year Experience with 13 Patients

Abstract

Emphysematous pyelonephritis is a life-threatening necrotizing renal infection characterized by the production of gas. Of 8,105 admissions to our diabetes service during the last 5 years we identified 13 cases. The patients were managed aggressively with fluids and antibiotics, followed by immediate nephrectomy. The mortality rate is 40 to 50 per cent, primarily owing to sudden septic complications.

194 Kidney preservation protocol for management of emphysematous pyelonephritis: Treatment modalities and follow-up

“…Emergency nephrectomy was considered by some authors as the surgical treatment of choice and a life-saving procedure for treating EPN [5,6]. This taboo was also rejected in recent years and a new treatment strategy of kidney preservation emerged [8][9][10][11].…”

“…This taboo was also rejected in recent years and a new treatment strategy of kidney preservation emerged [8][9][10][11]. The reasons for this change were the high mortality rates of emergency nephrectomy (17.6-40%) [5,6] and advances in image-guided procedures for drainage of the gas and infected fluids, using PCDs [9,10]. Chen et al [8], in their experience with 25 patients, suggested that percutaneous drainage is safe and effective for EPN, and that can result in cure.…”

“…Emergency nephrectomy after medical control of septicaemia and diabetes was reported [5,6]. The availability of effective antibiotics and advances in image-guided procedures resulted in the use of less aggressive surgical approaches such as percutaneous drainage [7][8][9].…”

Pielonefritis enfisematosa: Reporte de dos casos y revisión de la literatura.

“…La enfermedad es poco frecuente pero con elevada mortalidad debido a complicación séptica. Por lo general se presenta en mujeres adultas y en diabéticos (1)(2)(3)(4). Usualmente afecta a un riñón; la pielonefritis enfisematosa bilateral es rara (5).…”

Successful Medical Treatment of Emphysematous Pyelonephritis in a Renal Allograft Recipient

“…[1] It is a rare but serious complication after renal transplantation, and the clinical signs and symptoms of serious infection are often moderated by immunosuppressive drugs. Although 30-60% of all allograft recipients are treated for urinary tract infections, serious life-threatening sepsis occurs in less than one-fourth of these.…”