Emphysematous pyelonephritis in a diabetic leading to renaldestruction: pathological aspects of a rare case
- Author:
Archana Shetty
;
Vijaya C
;
Geethamani V
;
Savitha Anil Kumar
- Publication Type:Case Reports
- Keywords:
Emphysematous pyelonephritis;
diabetic;
renal destruction
- From:The Malaysian Journal of Pathology
2013;35(1):103-106
- CountryMalaysia
- Language:English
-
Abstract:
Emphysematous pyelonephritis is a severe, potentially fatal necrotizing pyelonephritis with a
variable clinical presentation, ranging from mild abdominal pain to septic shock. The majority
of cases occur in diabetics with poor glycemic control, while a small percentage may be due to
urinary tract obstruction. We present a case of a 57 year old male patient, diabetic on treatment,
presenting with left fl ank pain and poor stream of urine since one week. Laboratory tests revealed
that the patient had electrolyte imbalance, ketoacidosis and high blood sugar. Urine culture was
positive for Escherichia coli with a signifi cant colony count. Radiological examination gave a
diagnosis of Left Type 1 Emphysematous Pyelonephritis. Inspite of giving vigorous resuscitation
and antibiotics with nephrostomy, the patient had to undergo nephrectomy due to extensive renal
parenchymal destruction.
The nephrectomy specimen was studied in detail to know the histopathological fi ndings in a case
of diabetic patient with emphysematous pyelonephritis. We present this case not only because of
it being a rare complication of diabetes, but also to focus on the histopathological fi ndings of the
same, documentation of which is limited in literature.
- Full text:P020150925388527945666.pdf
