A Case of Emphysematous Pyelonephritis in a Diabetic Patients: Radiographic Demonstration of Gas Shadow in Renal Pelvis Experiance of Successful Management by Medical Treatment.
- Author:
Dong Joo LEE
1
;
Dong In HAWNG
;
Sang Kook HAN
;
Seok En KIM
;
Suk Joon PARK
Author Information
1. Department of Internal Medicine, Dae Lim St. Mary's Hospital, Seoul, Korea. ldj2000@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Emphysematous pyelonephritis;
Medical treatment
- MeSH:
Anti-Bacterial Agents;
Diabetes Mellitus;
Diagnosis;
Drainage;
Emergency Medical Services;
Humans;
Inflammation;
Kidney Pelvis*;
Mortality;
Nephrectomy;
Prognosis;
Pyelonephritis*;
Tomography, X-Ray Computed;
Urinary Tract
- From:Korean Journal of Nephrology
2001;20(2):319-322
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Emphysematous pyelonephritis is an uncommon and, but life-threatening necrotizing inflammation of renal parenchyme and perinephric tissue by gas-forming organisms. This disease is encountered mainly in patients with uncontrolled diabetes mellitus and/or urinary tract obstruction etc. Clinically, it appears as an acute severe clinical pyelonephritis that needs emergency care with poor prognosis. Though the pathogenesis of this disease is still pooly understood, radiographic demonstration of gas shadow in renal parenchyme and peri- nephritic tissue establishes the diagnosis of emphysematous pyelonephritis. The identification of this finding has been believed to consider incision and drainage or nephrectomy in addition to medical treatment, because of high mortality rate of this disease in spite of vigorous medical management. We herein present 1 diabetic patient with emphysematous pyelonephritis who responded to medical treatment alone. The patient was treated with antibiotics alone, the clinical signs and laboratory findings were improved, CT scan 1 month after medical treatment revealed absence of gas in the renal pelvis.
