Introduction and Objectives
We reviewed the clinical presentation, diagnosis and aspects of surgical or non-surgical management of patients presenting with emphysematous pyelonephritis.
Material and Methods
The clinical datas of 24 emphysematous pyelonephritis patients diagnosed between June 2000–April 2009 in our clinics were prospective reviewed. Also, the patients were divided into 3 groups according to their clinical status and severity of renal affect at computed tomography and managed with different treatment modalities in each.
The mean age of the patients was 61.8 years (range, 40–81). Diabetes mellitus was detected in 21 (87.5%) of 24 patients. Generally, flank or abdominal (%91.6), nausea-vomitting (%83.3) and high fever were the main symptoms of the patients when they first referred to the hospital. Ketoasidosis was detected in 5 (%20.8) of the patients in application time. Urinary calculi was detected in 9 of the patients while partial or total urinary obstruction in 10 of them. Escherichia coli was the predominantly pathogen identified in pus, blood, and urine culture. Six (%25) patients in mildy effected group 1 were treated only by antibiotics, while 13 (54.2%) patients in moderately effected group 2 were treated with antibiotics and percutaneous drainage. Five (20.8%) patients in severly effected group 3 were treated with nephrectomy. Two of these patients died after nephrectomy, while the other patients were succesfully treated.
Emphysematous pyelonephritis might be kept in mind in the differatial diagnosis of the patients suffering from abdominal pain, nausea-vomiting with associated urological anomalies and diabetes mellitus with unregulated blood glucose. The patients with emphysematous pyelonephritis should be managed according to the severity of renal affect.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.