Emphysematous pyelonephritis (EPN) is a rare and serious necrotizing infection that is potentially life-threatening. It has been seldom reported in kidney grafts and is usually caused by Gram-negative bacteria, with some case reports caused by anaerobic bacteria, and has been closely associated with poorly controlled diabetes mellitus (DM) and urinary tract structural abnormalities. There are no reports of EPN of fungal etiology in kidney grafts. We present a case of a 53-year-old kidney transplant recipient with a history of DM, active vesicoureteral reflux, and recurrent urinary tract infections who developed EPN in the kidney allograft caused by Candida glabrata, 3 weeks after starting treatment with empagliflozin, with an aggressive course that required urgent transplant nephrectomy.
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http://dx.doi.org/10.1159/000507259 | DOI Listing |
Radiol Case Rep
March 2025
Emergency Radiology Department, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco.
Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma by gas-forming organisms, with a risk of the gas extending into peri-nephric or para-renal spaces and in advanced cases, the involvement may be extensive and bilateral. It is a common complication in patients with long-term diabetes, primarily caused by Gram-negative organisms or, in some cases, anaerobes. The diagnosis of emphysematous pyelonephritis is made by clinical features and confirmed by computed tomography.
View Article and Find Full Text PDFFournier's gangrene is a grave necrotizing fasciitis that primarily affects the perineum, spreading through the fascias and leading to significant tissue destruction. The involvement of the urethra in necrosis is extremely rare, if not anecdotal. Emphysematous pyelonephritis, is a urinary infection with a high risk of progression to sepsis.
View Article and Find Full Text PDFAm J Case Rep
December 2024
Department of Radiology, University of Tennessee Medical Center-Knoxville, Knoxville, TN, USA.
BACKGROUND Emphysematous urinary tract infections are rare and serious conditions that are often multifactorial in etiology and may be associated with the presence of renal stones. Diagnosis can be made by finding gas within the renal collecting system or parenchyma. However, the radiographic finding of gas within a renal stone is rare and little has been published to describe the significance of this finding, its promoting factors, and management.
View Article and Find Full Text PDFCureus
December 2024
Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, JPN.
Cureus
November 2024
Nephrology, Stanley Medical College, Chennai, IND.
Background Diabetes mellitus (DM) is a prevalent predisposing factor for urinary tract infections (UTIs). Among hospitalized patients with acute pyelonephritis, UTIs are more common, severe, and associated with worse outcomes, particularly in those with type 2 DM. Pyelonephritis in DM patients is more frequently bilateral and linked to greater complications, with 90% of emphysematous pyelonephritis (EMPN) and cystitis cases occurring in diabetic individuals.
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