My flanks aches: Emphysematous pyelonephritis in a newly diagnosed case of diabetes mellitus

Okunowo, Bolanle; Omidiji, Olubukola; Jeje, Emmanuel Ajibola; Fasanmade, O.A

doi:10.4103/npmj.npmj_162_19

Cited by 3 publications

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“…17 Neutrophilic leucocytosis, high ESR, high CRP and poor glycaemic status are consistent features as most EPN cases have DM. [1][2][3][13][14][15][16] Occasionally an episode of EPN unmasks previously undiagnosed DM, 3,18 which happened with one of our patients. E. coli is the most commonly isolated organism in most series.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous Pyelonephritis: Experience at a Tertiary Care Hospital in Bangladesh

Rahim

Ananna

Iqbal

et al. 2021

Journal of the Royal College of Physicians of Edinburgh

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Background Emphysematous pyelonephritis (EPN) is a necrotizing infection of the renal parenchyma, collecting system and/or perinephric tissues, characterized by gas accumulation. We describe clinical, laboratory and imaging characteristics and in-hospital outcomes of patients with EPN. Methods This retrospective observational study was carried out at BIRDEM General Hospital, Dhaka, Bangladesh between 2014 and 2020. Results We followed 20 patients (mean age 49.4 years; females 70%). Risk factors for EPN were diabetes mellitus (in 100%) and renal stones (in 10%). Fever, loin pain, vomiting and dysuria were common. Complications included acute kidney injury (AKI, 70%; mostly stage 1, 78.6%), hyponatraemia (55%) and bacteraemia (15%). Escherichia coli was the most common (60%) urinary isolate. Most patients (80%) had class 2 EPN, with 15% class 3B and 5% class 3A. Besides medical management, four (20%) required surgery (nephrectomy in 3). Nephrectomised patients had a higher radiological class (p = 0.032) and incidence of AKI (p = 0.034). No deaths occurred. Conclusion EPN occurred predominantly in female diabetic patients, who presented with fever, loin pain, vomiting and dysuria. Two-thirds of patients had AKI and one-fifth required surgery, and there were no deaths.

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Section: Discussionmentioning

confidence: 99%

Emphysematous Pyelonephritis: Experience at a Tertiary Care Hospital in Bangladesh

Rahim

Ananna

Iqbal

et al. 2021

Journal of the Royal College of Physicians of Edinburgh

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Emphysematous pyelonephritis: A rare case report from Syria

Al-Hajjaj

Tallaa

2022

Annals of Medicine &Amp; Surgery

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Introduction Emphysematous pyelonephritis is a rare necrotizing infection of the kidney. It should be diagnosed early because it has a bad prognosis. Treatments range from intravenous antibiotics to nephrectomy in severe cases. Presentation of case A 67 years old female with uncontrolled diabetes mellitus presented with fever, right flank pain, and dysuria. Computed tomography for abdominal and pelvis showed gas inside the right kidney. After administration of intravenous antibiotics, she underwent right nephrectomy. Next, she was admitted to intensive care unit for monitoring. After three days, she was discharged with no complains. Follow-up for three months showed full recovery. Clinical discussion Emphysematous pyelonephritis is an emergent condition. A history of uncontrolled diabetes mellitus with current flank pain with fever raises the suspicion. Computed tomography could be performed to confirm the diagnosis. Conclusion Severe cases of emphysematous pyelonephritis are an emergent condition that needs nephrectomy.

My flanks aches: Emphysematous pyelonephritis in a newly diagnosed case of diabetes mellitus

Cited by 3 publications

References 0 publications

Emphysematous Pyelonephritis: Experience at a Tertiary Care Hospital in Bangladesh

Emphysematous Pyelonephritis: Experience at a Tertiary Care Hospital in Bangladesh

Emphysematous pyelonephritis: A rare case report from Syria

Emphysematous pyelonephritis in a young male Syrian patient: A rare case report

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