Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Apr 2004)
Report of a case of medical treatment of emphysematous pyelonephritis
Abstract
Background and Objective: Emphysematous pyelonephritis is an acute and necrotizing parenchymal and perinephric infection. It is a rare and life threatening condition. To reach a successful outcome, early diagnosis and treatment is most important. Nowadays, the use of CT scan and antibiotics has enabled us to replace surgery with medical treatment in some cases. Cases: A 74-year-old man referred with bad general condition, decrease in level of consciousness, fever, flank pain and dysuria from a few days ago. Lab tests were compatible with a urinary tract infection and acute renal failure. Abdominal sonography and CT scan showed gas in both renal parenchymas. The diagnosis of emphysematous pyelonephritis was made. Hemodynamic support, control of blood sugar and IV antibiotics were applied. Uremic syndrome led to hemodialysis. Ultimately signs and symptoms improved and the infection was treated and the patient was discharge. Gradually renal function improved and hemodialysis was deceased. Conclusion: Early medical treatment can replace surgery in this life threatening condition.
