Tailored treatment approach for emphysematous pyelonephritis

Urol Int. 2011;86(4):444-7. doi: 10.1159/000323604. Epub 2011 Apr 20.

Abstract

Objective: We evaluated the clinical presentation, diagnosis and management of patients presenting with emphysematous pyelonephritis (EP).

Patients and methods: The clinical data of 24 EP patients diagnosed between 2000 and 2009 were retrospectively reviewed. The management strategies were discussed according to the severity of condition at presentation.

Results: The mean age of the patients was 61.8 years. Diabetes mellitus was detected in 21 (87.5%) of them. Escherichia coli was the predominant pathogen. There were 6 patients (25%) who recovered with antibiotic treatment only (mild). Percutaneous drainage in addition to antimicrobial chemotherapy was necessary in 13 cases (54%) (moderate). The remaining 5 patients (21%) were treated by nephrectomy (severe).

Conclusions: EP is a serious infection that can display a fatal progression despite ablative treatment but there are also some cases with mild or moderate severity that can be successfully treated without nephrectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Diabetes Complications / therapy
  • Diabetes Mellitus / therapy
  • Drainage
  • Emphysema / complications
  • Emphysema / therapy*
  • Escherichia coli Infections / metabolism
  • Female
  • Humans
  • Kidney / pathology
  • Male
  • Middle Aged
  • Nephrectomy / methods
  • Pyelonephritis / complications
  • Pyelonephritis / therapy*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents