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Case Report

NMJ. 2012; 1(1): 41-44

Emphysematous Pyelonephritis-Conservatively Managed

Praveen Kumar Kolla, Desai Madhav, Satish Reddy, Suneetha Pentyala, Panil Kumar, Rama Mohan Pathapati.

Emphysematous pyelonephritis (EPN) is a severe, necrotizing renal parenchymal infection characterized by production of intraparenchymal gas.EPN predominantly affects female diabetics and immunocompromised patients. In a three year period 2008-2011, a total of 8 patients were admitted to our hospital. All of them were diabetics and both males and females were equally affected. These patients showed vague symptoms at admission and frequently presented with fever, loin pain, dysuria and pyuria necessitating urgent medical attention. EPN required radiological diagnosis. CT scan revealed bilateral EPN with urinary obstruction and hydronephrosis in 50% of patients. Escherichia coli was found to be the causative organism in all the patients. Treatment comprised of resuscitation, normalization of serum electrolytes and blood sugars, administration of parentral antibiotics and relieving uretric obstruction if present. All the patients improved with conservative management without any mortality.

Key words: Emphysematous pyelonephritis, diabetes,renal dysfunction, hydronephrosis, conservative management

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