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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Emphysematous pyelonephritis (EPN) is a rare, life-threatening infection, and misdiagnosis as uncomplicated pyelonephritis is potentially fatal. Point-of-care ultrasound (POCUS) is a valuable tool for evaluation of the kidneys in patients with septic shock and pyelonephritis. While used primarily to assess for the complication of obstruction and hydronephrosis, POCUS may also detect signs of EPN and prompt surgical consultation for nephrectomy. We present a case in which the emergency physician diagnosed EPN by POCUS in a patient with septic shock and pyelonephritis.
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PMID:Emphysematous Pyelonephritis: Bedside Ultrasound Diagnosis in the Emergency Department. 2984 19

Emphysematous pyelonephritis is a rare but life-threatening infection characterized by an accumulation of gas in the renal parenchyma. A high mortality rate was reported, and timely administration of broad-spectrum antibiotics for enteric gram-negative bacilli, such as Escherichia coli, Enterobacter, and Klebsiella pneumoniae, was recommended for improving the clinical outcome. Computed tomography is a useful tool for identifying gas accumulation within the perirenal space. Abdominal ultrasound and abdominal plain film are alternative options with lower accuracy rates. Here, we present the case of a 49-year-old male patient who presented with acute-onset progressive abdominal cramping pain and dysuria. Diffuse bilateral opacities over the lung field and a heterogeneous mass with air density in the abdomen were found on radiological examination. Multiple septic pulmonary emboli and emphysematous pyelonephritis were diagnosed using computed tomography. After emergency percutaneous nephrostomy and administration of broad-spectrum antibiotics, the patient was discharged in a stable condition and followed up at the outpatient department. This report also describes the clinical and imaging features of emphysematous pyelonephritis and highlights that early diagnosis and timely administration of broad-spectrum antibiotics may help avoid a potentially devastating outcome.
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PMID:Septic Pulmonary Emboli or Pulmonary Metastasis in a Patient with Diabetes Mellitus? 3001 37

Emphysematous pyelonephritis is a rare form of acute necrotizing pyelonephritis. It is a gas-producing, necrotizing infection involving the renal parenchyma and surrounding tissues. It is associated with high mortality and morbidity. In the majority of cases, patients with long-standing diabetes and poor glycemic control are affected. We report the case of a 67 yr old female who survived severe sepsis due to emphysematous pyelonephritis. Potential therapeutic strategies in the aftermath from a diabetologist's point of view are discussed.
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PMID:Emphysematous pyelonephritis - a rare complication of diabetes mellitus. 3009 35

Emphysematous pyelonephritis (EPN) is a rare form of pyelonephritis causing a severe infection of the renal system that includes gas in the renal parenchyma, collecting system and surrounding tissue often presenting with sepsis. We report the case of a 60-year-old male with poorly controlled insulin dependent diabetes mellitus who presented with abdominal pain, nausea, vomiting, and "peeing air." CT scan revealed air extending from the left renal parenchyma, perinephric fat and into the bladder, consistent with emphysematous pyelonephritis. Bedside point-of-care ultrasound (POCUS) subsequently revealed dirty shadowing and reverberation artifacts in the left kidney and the bladder consistent with gas in the urinary collecting system. By understanding the identifying artifacts seen with EPN, reflective shadow and reverberation artifact, the emergency physician may be alerted to the diagnosis sooner. Often this illness presents similarly to simple, acute pyelonephritis or undifferentiated sepsis. Therefore, POCUS allows for real time consideration of this condition while in the emergency department and thus prompter time to treatment.
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PMID:Emphysematous Pyelonephritis Presenting as Pneumaturia and the Use of Point-of-Care Ultrasound in the Emergency Department. 3156 45

BACKGROUND Emphysematous osteomyelitis of the spine is characterized by intravertebral or intraosseous air. Emphysematous pyelonephritis (EP) is the infection of the renal parenchyma and perirenal tissues caused by gas forming microorganisms and thus is characterized by gas formation. Prompt diagnosis and initiation of necessary treatment is crucial, as both entities are associated with high mortality rates. CASE REPORT A 57-year-old female with uncontrolled hyperglycemia presented to the emergency department with history of sudden onset of weakness, nausea, vomiting and diarrhea for 3 days and with a fall on the same level the previous day. Laboratory examinations revealed leukocytosis, lymphopenia, thrombocytopenia, deteriorated renal function, and hyperglycemic hyperosmolar non-ketotic state. She was placed on aggressive intravenous hydration and insulin infusion pump. Due to the deterioration of her medical condition, she underwent abdominal and pelvic CT scanning that revealed emphysematous osteomyelitis of the spine and emphysematous pyelonephritis. Despite vigorous fluid resuscitation and systemic broad-spectrum antibiotic therapy, the patient's condition deteriorated further and eventually led to death within 48 h. CONCLUSIONS This case of fatal emphysematous osteomyelitis of the spine and EP serves as a significant reminder of those rare life-threatening entities, which affect patients with comorbidities, such as diabetes mellitus and other etiologies causing immunosuppression. The aim of the present case report is to highlight the importance and contribution of computed tomography in diagnosing these conditions and to emphasize the rare coexistence of these 2 emphysematous entities.
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PMID:Simultaneous Diagnosis of Emphysematous Osteomyelitis and Emphysematous Pyelonephritis in a Diabetic Patient. 3178 44

Emphysematous pyelonephritis (EPN) is a rare, severe necrotising infection of the renal parenchyma and surrounding tissues. It is usually life-threatening and should be promptly treated. Here, we report a clinical case of a 54-year-old male who presented with the left flank pains of 3-week duration. The flank pain was described as dull, constant with associated fever. He was diagnosed with diabetes mellitus (DM) while on admission. A clinical diagnosis of the left pyelonephritis was made. The abdominopelvic computed tomography scan confirmed bilateral EPN by showing a thin film of perinephric fluid (13.2 ml) in the left lower pole. He was managed conservatively with fluid therapy, adequate glycaemic control and intravenous antibiotics with no percutaneous drainage done. This highlights the importance of early initiation of appropriate medical treatment to avoid interventional urological procedures of nephrectomy. It also highlights the importance of clinical suspicion of EPN in patients presenting with symptoms of urinary tract infection and DM.
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PMID:My flanks aches: Emphysematous pyelonephritis in a newly diagnosed case of diabetes mellitus. 3200 64

Emphysematous pyelonephritis (EPN) is an acute life-threatening gas-forming necrotizing infection of the renal parenchyma and its surrounding tissues. EPN requires early diagnosis and management because of related life-threatening septic complications. Gram-negative bacteria remain the most common causative organisms. Although candida species as a causative pathogen in emphysematous pyelonephritis is very rare, we report a rare case of emphysematous pyelonephritis caused by candida species successfully managed with unilateral nephrectomy and outcome for flow up in one year.
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PMID:Emphysematous pyelonephritis caused by candida species: A case report and outcome of 1 year follow-up. 3205 47

Emphysematous pyelonephritis is a life-threatening, urologic emergency. We present the case of a 54-yearold female who was found to have a large volume of air in her renal vein and inferior vena cava from severe emphysematous pyelonephritis. In this case report, the medical and operative management of this patient are reviewed, and the literature on the management of emphysematous pyelonephritis is summarized.
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PMID:Gas in the inferior vena cava from severe emphysematous pyelonephritis. 3233 41

Emphysematous pyelonephritis is a necrotizing renal infection that results in the presence of gas in renal parenchyma, collecting system, and surrounding tissues. Ninety-five percent of the patients have underlying uncontrolled diabetes mellitus, but non-diabetic patients may be affected due to ureteral obstruction and infection with gas forming pathogens. Several poor prognostic factors have been described, such as thrombocytopenia, acute kidney failure, impaired consciousness, and shock. We present a case of a 41-year-old female who attends to the emergency department with signs of septic shock and diffuse abdominal pain. The diagnosis of emphysematous pyelonephritis in a horseshoe kidney was confirmed.
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PMID:Emphysematous Pyelonephritis in a Horseshoe kidney. 3272 13

Emphysematous pyelonephritis (EPN) is a progressive necrotizing infection of the renal parenchyma, collecting system and perinephric tissue. A 36-year female with uncontrolled diabetes, presented with left emphysematous pyelonephritis, with air in the infra-hepatic inferior vena cava (IVC). She was hydrated, treated with intravenous antibiotics, insulin. Percutaneous nephrostomy with Double J stenting was done in modified supine position. Patient was discharged with nephrostomy. Two weeks later, flexible ureterorenoscopy was done and obstructing papillary necrosis removed. Pneumo-vena cava due to emphysematous pyelonephritis is quite rare and careful evaluation is required. Prompt intervention is life saving and obviates the need for nephrectomy.
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PMID:Emphysematous pyelonephritis with gas in inferior vena cava. 3310 88


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