AI Article Synopsis
- Emphysematous pyelonephritis (EPN) is a serious kidney disease caused by gas-producing bacteria, often linked to conditions like uncontrolled diabetes and urinary obstruction.
- Diagnosis is primarily done through abdominal CT scans, and while surgical options exist, conservative treatments are preferred to reduce the need for nephrectomy.
- Cases classified as grade IV, impacting both kidneys, have high mortality rates and require a multidisciplinary treatment approach, as illustrated by a case of an elderly woman with severe EPN and related complications who ultimately needed bilateral radical nephrectomy.
Article Abstract
Emphysematous pyelonephritis (EPN) is a severe disease of the renal system in which gas formed by facultative anaerobe microorganisms accumulates, being the most representative causative agent. A series of conditions foster its development including uncontrolled diabetes mellitus, diabetic nephropathy and obstructive uropathy. Abdominal CT scan continues to be the gold standard for diagnosis. Currently, nephrectomy is avoided as much as possible, and more conservative treatments are given. Mortality is still as high as 21 % despite new therapeutic options, all of which are mostly surgical. The rarest cases are those classified as grade IV, which affect both kidneys; these are considered the most lethal of the clinical presentations and they are also of particular interest, since a multidisciplinary team must be in charge of treatment. Herein, we present the case of an elderly woman with chronic diseases and a presentation of massive emphysematous pyelonephritis concurrent with emphysematous cystitis and pneumoperitoneum, who required bilateral radical nephrectomy despite efforts of preserving at least one of the kidneys.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709098 | PMC |
| http://dx.doi.org/10.1016/j.idcr.2022.e01646 | DOI Listing |
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