title: [Escherichia coli-induced emphysematous pyelonephritis in a diabetic patient with polycystic kidney disease].
abstract: Emphysematous pyelonephritis is a rare, necrotizing infection of the kidney and the perirenal space resulting in the formation of gas in both structures and associated with a high mortality rate. In 90% of cases it affects one kidney only; in the remaining 10% with bilateral emphysematous pyelonephritis aggressive surgical intervention may be required. Women are much more frequently affected than men, with diabetes mellitus (in 70-90% of cases) and urinary tract obstruction being common predisposing conditions. The pathogenesis of the disease is linked to four main factors: the presence of gasforming bacteria; hyperglycemia; inadequate tissue perfusion; and reduced immune response. Lactose-fermenting bacteria such as Escherichia coli and Klebsiella pneumoniae are the most common infectious agents. We report a case of unilateral emphysematous pyelonephritis due to a ruptured cyst infected by E. coli in a diabetic patient with polycystic kidney disease. The resulting septic shock necessitated an emergency right nephrectomy.
authors.affiliation: U.O.C. Nefrologia e Dialisi, Ospedale G. Fracastoro di San Bonifacio, Verona, Italy. enzocos77@libero.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cosentini
authors.forename: Alex
authors.initials: A
authors.lastname: Cosaro
authors.forename: Linda
authors.initials: L
authors.lastname: Gammaro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lidestri
authors.forename: Lamberto
authors.initials: L
authors.lastname: Oldrizzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maschio
mesh_terms: D003928:Diabetic Nephropathies / Q000150:complications*; D004646:Emphysema / Q000382:microbiology; D004927:Escherichia coli Infections; D005260:Female; D006801:Humans; D008875:Middle Aged; D007690:Polycystic Kidney Diseases / Q000150:complications*; D011704:Pyelonephritis / Q000382:microbiology*