title: [Two cases of emphysematous pyelonephritis successfully treated by transurethral catheterization].
abstract: Cases 1 and 2 were a 84-year-old, 64-year-old female relatively. Case 2 had a history of uncontrolled diabetes mellitus. Both cases were referred to our hospital with a chief complaint of high fever. Initial diagnosis was acute pyelonephritis based on the findings of pyuria and right costovertebral angle knock pain. Abdominal computed tomography (CT) scan revealed a gas shadow in the right renal pelvis and calyx with right ureteral stone. The definitive diagnosis was emphysematous pyelonephritis (EPN). We selected transureteral catheterization into the right ureter immediately. Escherichia coli was identified from urine culture. Conservative therapy with antibiotics was also effective and general condition improved. Herein we discussed the etiology, symptomatology, choice of treatment and prognosis of emphysematous pyelonephritis. Recently CT is an effective imaging method for diagnosis at an early stage. Antibiotics therapy combined with transureteral drainage of gas-forming urolithiasis is effective as the initial conservative therapy.
authors.affiliation: Department of Urology, Ikeda Municipal Hospital.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kinouchi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Kouji
authors.initials: K
authors.lastname: Hatano
authors.forename: Masao
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takada
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Hara
mesh_terms: D000369:Aged, 80 and over; D015310:Cefotiam / Q000008:administration & dosage; D004646:Emphysema / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004927:Escherichia coli Infections; D005260:Female; D006801:Humans; D008875:Middle Aged; D011704:Pyelonephritis / Q000000981:diagnostic imaging / Q000628:therapy*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014546:Urinary Catheterization
chemical_list: D015310:Cefotiam