title: Tailored treatment approach for emphysematous pyelonephritis.
abstract: OBJECTIVE
  We evaluated the clinical presentation, diagnosis and management of patients presenting with emphysematous pyelonephritis (EP).
  
  
  METHODS
  The clinical data of 24 EP patients diagnosed between 2000 and 2009 were retrospectively reviewed. The management strategies were discussed according to the severity of condition at presentation.
  
  
  RESULTS
  The mean age of the patients was 61.8 years. Diabetes mellitus was detected in 21 (87.5%) of them. Escherichia coli was the predominant pathogen. There were 6 patients (25%) who recovered with antibiotic treatment only (mild). Percutaneous drainage in addition to antimicrobial chemotherapy was necessary in 13 cases (54%) (moderate). The remaining 5 patients (21%) were treated by nephrectomy (severe).
  
  
  CONCLUSIONS
  EP is a serious infection that can display a fatal progression despite ablative treatment but there are also some cases with mild or moderate severity that can be successfully treated without nephrectomy.
authors.affiliation: Department of Urology, Baskent University Faculty of Medicine, Ankara, Turkey. kuzgunbay33@yahoo.com
authors.forename: Baris
authors.initials: B
authors.lastname: Kuzgunbay
authors.forename: Tahsin
authors.initials: T
authors.lastname: Turunc
authors.forename: Naime
authors.initials: N
authors.lastname: Tokmak
authors.forename: Tuba
authors.initials: T
authors.lastname: Turunc
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dirim
authors.forename: Cem
authors.initials: C
authors.lastname: Aygun
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozkardes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D048909:Diabetes Complications / Q000628:therapy; D003920:Diabetes Mellitus / Q000628:therapy; D004322:Drainage; D004646:Emphysema / Q000150:complications / Q000628:therapy*; D004927:Escherichia coli Infections / Q000378:metabolism; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D011704:Pyelonephritis / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents