title: Emphysematous pyelonephritis: diagnosis and treatment.
abstract: Emphysematous pyelonephritis is a rare life-threatening bacterial infection usually occurring in patients with diabetes mellitus and producing gas within the renal parenchyma and/or perirenal tissue. We add four cases to the 62 previously reported in the literature. The overall mortality is 38%, with only 29% survival for those treated medically compared to 71% for those given both medical and surgical treatment. Early diagnosis with the aid of renal ultrasonography and/or computerized axial tomography and aggressive early combined medical-surgical management are emphasized.
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D048909:Diabetes Complications; D004322:Drainage; D004646:Emphysema / Q000209:etiology*; D004927:Escherichia coli Infections / Q000150:complications; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D011704:Pyelonephritis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014567:Urography
chemical_list: D000900:Anti-Bacterial Agents