title: [A Case of Emphysematous Pyelonephritis with Pneumoderma Treated by Open Surgical Drainage].
abstract: Emphysematous pyelonephritis (EPN) is an acute, severe necrotizing infection of the renal parenchyma and perirenal tissue. A 72-year-old female patient with uncontrolled diabetes mellitus was admitted to a hospital with loss of consciousness and, fever. Laboratory data suggested acute inflammation and hyperosmolar hyperglycemic syndrome. The left EPN was accurately diagnosed after abdominal computed tomographic (CT) scan revealed renal parenchymal gas and fluid within the subcutaneous tissue and mediastinum. The patient was transferred to our institution and underwent emergent open surgical drainage. However, a CT scan performed 3 days after the drainage revealed the presence of fluid in the left perinephric space. CT-guided drainage of the left perinephric fluid was performed. The patient was finally discharged after complete recovery from severe inflammation.
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Shimura
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Tabata
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Dai
authors.initials: D
authors.lastname: Koguchi
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Amano
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Morihiro
authors.initials: M
authors.lastname: Nishi
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Fujita
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Satoh
authors.affiliation: The Department of Urology, Kitasato University School of Medicine.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Iwamura
mesh_terms: D000368:Aged; D048909:Diabetes Complications; D004322:Drainage / Q000379:methods*; D004646:Emphysema / Q000150:complications*; D005260:Female; D006801:Humans; D011704:Pyelonephritis / Q000150:complications / Q000209:etiology / Q000601:surgery*; D013352:Subcutaneous Emphysema / Q000150:complications*