Bilateral emphysematous pyelonephritis and emphysematous cystitis with autosomal-dominant polycystic kidney disease: is conservative management justified?
OBJECTIVE
To report a case of bilateral emphysematous pyelonephritis (EPN) and emphysematous cystitis in a 64-year-old diabetic male with autosomal-dominant polycystic kidney disease (ADPKD).


METHODS
A 64-year-old diabetic male presented with worsening of renal function and fluid overload. Diagnosis was confirmed by computerized tomography (CT scan) and conservative management with broad-spectrum antibiotics was instituted. There was good clinical response and repeated CT scan showed complete resolution.


CONCLUSIONS
This case shows that conservative management is an acceptable alternative to surgery in EPN occurring with ADPKD. However, it is recommended that patients should be closely monitored, both clinically and radiologically, and percutaneous catheter drainage or surgical intervention carried out whenever deemed necessary.
Arun
Narayanaswamy
N
Departments of Surgery (Urology Unit) and Nephrology, Al-Amiri Hospital, Kuwait. nandarun@hotmail.com
Hussain
Abdullatif
A
Kapoor
Madan Mohan
MM
Abul
Fawzi
F
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003556:Cystitis / Q000150:complications / Q000188:drug therapy*; D004646:Emphysema / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D011704:Pyelonephritis / Q000150:complications / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed
D000890:Anti-Infective Agents