[Bilateral emphysematous pyelonephritis, a rare cause of acute renal failure].
BACKGROUND
The emphysematous pyelonephritis is a life-threatening complication of a bacterial interstitial nephritis, and it occurs mainly in diabetics. The infection with optional anaerobic microorganisms, which are able to produce gas, is supported by a reduced state of resistance, a high glucose level in the tissue in diabetic derailment and ischemia in the infected organ, for example by a kidney infarction or by an obstructive uropathy. Mostly the inflammation occurs unilateral, only in 10% of all cases both kidneys are affected. Computer tomography allows a fast diagnosis by demonstrating gas accumulation in the kidney. Surgical measures and antibiotic therapy are the principal therapeutic methods.


METHODS
The example of a 55-year-old diabetic man with bilateral emphysematous pyelonephritis demonstrates the diagnostic and therapeutic possibilities. After a fast diagnostic procedure, immediate hemodialysis in uremia and bilateral nephrectomy let the patient survive in a stable clinical condition dependent on regular dialysis treatment.
Ahlert
K
K
Klinik für Nieren- und Hochdruckkrankheiten, Augusta-Kranken-Anstalt Bochum, Akademisches Lehrkrankenhaus, Universität Bochum.
Hecking
E
E
Schüller
J
J
D058186:Acute Kidney Injury / Q000382:microbiology* / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003937:Diagnosis, Differential; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy