Emphysematous pyelonephritis: an emergency indication for the plain abdominal radiograph.
We report the case of a 59-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain of three days duration. The diagnosis was established by a plain abdominal radiograph in the emergency department. Aggressive rehydration, control of diabetes, broad-spectrum antibiotic therapy, and early right nephrectomy resulted in rapid clinical improvement. Emphysematous pyelonephritis is rare and often fatal. Survival depends on early diagnosis and aggressive combined medical and surgical management.
Ouellet
L M
LM
Department of Emergency Medicine, University of Southern California 90033.
Brook
M P
MP
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000628:therapy; D004630:Emergencies; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D004927:Escherichia coli Infections / Q000150:complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D009392:Nephrectomy; D011704:Pyelonephritis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed; D014552:Urinary Tract Infections / Q000150:complications
D000900:Anti-Bacterial Agents