title: [Emphysematous pyelonephritis. Epidemiological, clinical, biological, bacteriological, radiological, therapeutic and prognostic features. Retrospective study of 30 cases].
abstract: BACKGROUND
  Emphysematous pyelonephritis is an uncommon, necrotizing bacterial infection of the kidney. It is a severe, life threatening affection.
  
  
  OBJECTIVE
  To study the epidemiological, clinical, biological, bacteriological and radiological features of this affection, and to describe its therapeutic management and prognostic characteristics.
  
  
  METHODS
  We conducted a retrospective study including 30 patients who were treated for an emphysematous pyelonephritis, in Charles Nicolle hospital department of urology, from 1987 to 2009.
  
  
  RESULTS
  Emphysematous pyelonephritis generally affects adults. It is especially favored by diabetes and urinary tract obstruction. Escherichia coli is the main causative agent. Uroscan is the key of diagnosis. It is both medical and surgical emergency; the treatment combines intensive care with appropriate antibiotics and often drainage. Nephrectomy may be necessary from the outset, or after drainage failure. Prognosis is poor, with a high mortality rate (23 %), in our series.
  
  
  CONCLUSIONS
  Management of emphysematous pyelonephritis poses real problems. This affection is still threatening, despite of advances in intensive care.
authors.affiliation: Service d'urologie, Hopital Charles Nicolle de Tunis, Tunisie.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Cherif
authors.forename: Walid
authors.initials: W
authors.lastname: Kerkeni
authors.forename: Abderrazak
authors.initials: A
authors.lastname: Bouzouita
authors.forename: Mohamed Slim
authors.initials: MS
authors.lastname: Selmi
authors.forename: Amine
authors.initials: A
authors.lastname: Derouiche
authors.forename: Mohamed Riadh
authors.initials: MR
authors.lastname: Ben Slama
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chebil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004646:Emphysema / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011704:Pyelonephritis / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D014416:Tunisia