title: Successful medical treatment of acute bilateral emphysematous pyelonephritis.
abstract: Emphysematous pyelonephritis most often presents as an acute medical emergency, typically in a septic diabetic patient with acute renal failure. The management of this condition has traditionally been surgical, with nephrectomy. However, some recent reports have described successful medical interventions. We describe a case of acute bilateral emphysematous pyelonephritis in a frail patient not suitable for bilateral nephrectomy and long-term dialysis. This condition was managed medically, not surgically, with intensive antibiotic and circulatory support. The outcome was complete recovery after months of hospital-based treatment. We discuss the management of this rare but important condition in detail.
authors.affiliation: Renal Department, Guy's Hospital, London, England.
authors.forename: H
authors.initials: H
authors.lastname: Tahir
authors.forename: G
authors.initials: G
authors.lastname: Thomas
authors.forename: N
authors.initials: N
authors.lastname: Sheerin
authors.forename: H
authors.initials: H
authors.lastname: Bettington
authors.forename: J M
authors.initials: JM
authors.lastname: Pattison
authors.forename: D J
authors.initials: DJ
authors.lastname: Goldsmith
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004646:Emphysema / Q000628:therapy*; D006440:Hemofiltration; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D011704:Pyelonephritis / Q000628:therapy*; D018805:Sepsis / Q000150:complications / Q000188:drug therapy; D013845:Thienamycins / Q000627:therapeutic use*; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014640:Vancomycin; D000077731:Meropenem