title: Acute bilateral emphysematous pyelonephritis successfully managed by medical therapy alone: a case report and review of the literature.
abstract: BACKGROUND
  Bilateral emphysematous pyelonephritis is a life threatening condition usually occurring in diabetics. Management of this condition has traditionally been aggressive and surgery is considered mandatory. However, this is itself a hazardous intervention in a septic, unstable patient with circulatory or liver failure. When bilateral disease is present, the need for long-term dialysis is obviously unavoidable.
  
  
  METHODS
  We herein report one of the few cases of bilateral emphysematous pyelonephritis successfully managed by non-surgical treatment.
authors.affiliation: Department of Internal Medicine, Division of Medicine, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico. gmf368@yahoo.com
authors.forename: Guillermo
authors.initials: G
authors.lastname: Flores
authors.forename: Haiko
authors.initials: H
authors.lastname: Nellen
authors.forename: Francisco
authors.initials: F
authors.lastname: Magaña
authors.forename: Juan
authors.initials: J
authors.lastname: Calleja
mesh_terms: D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004298:Dopamine / Q000627:therapeutic use; D004646:Emphysema / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D011704:Pyelonephritis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D007004:Hypoglycemic Agents; D007328:Insulin; D002443:Ceftriaxone; D000583:Amikacin; D004298:Dopamine