title: Successful treatment of bilateral emphysematous pyelonephritis in a uremic patient without nephrectomy.
abstract: Emphysematous pyelonephritis (EPN) is a severe and complicated renal infection characterized by gas formation within the infected kidney and its surrounding tissues. Early diagnosis with a high index of suspicion and aggressive treatment are important for improving outcome. Bilateral involvement is rare, and surgical intervention is usually required because of its high mortality rate. A literature review found that EPN has rarely been noted in chronic dialysis patients, and those who show bilateral EPN have demonstrated no survival at all until now. Herein, we presented a 51-year-old diabetic uremic woman who developed right emphysematous pyelitis initially and then progressed to bilateral EPN when hospitalized. Percutaneous drainage (PCD) with simultaneous antibiotic therapy successfully eradicated her renal infection. In this study, all reported cases of EPN in chronic dialysis patients were also reviewed.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Chang-Gung Memorial Hospital- Kaohsiung Medical Center, Chang-Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Su
authors.forename: Lung-Chih
authors.initials: LC
authors.lastname: Lee
authors.forename: Chien-Hao
authors.initials: CH
authors.lastname: Lai
authors.forename: Yi-Hsi
authors.initials: YH
authors.lastname: Wang
authors.forename: Yu-Kun
authors.initials: YK
authors.lastname: Yang
authors.forename: Hwee-Yeong
authors.initials: HY
authors.lastname: Ng
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Lee
authors.forename: Yu-Che
authors.initials: YC
authors.lastname: Tsai
authors.forename: Feng-Rong
authors.initials: FR
authors.lastname: Chuang
authors.forename: Chien-Te
authors.initials: CT
authors.lastname: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004322:Drainage; D004646:Emphysema / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications / Q000628:therapy*; D014511:Uremia / Q000150:complications*
chemical_list: D000900:Anti-Bacterial Agents