Successful medical treatment of acute bilateral emphysematous pyelonephritis.
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.
Tahir
H
H
Renal Department, Guy's Hospital, London, England.
Thomas
G
G
Sheerin
N
N
Bettington
H
H
Pattison
J M
JM
Goldsmith
D J
DJ
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*
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014640:Vancomycin; D000077731:Meropenem