Infect Chemother.  2011 Aug;43(4):339-342. 10.3947/ic.2011.43.4.339.

Analysis of Treatment Modalities of 24 Cases with Emphysematous Pyelonephritis

• Song PH
• Kim HT

• KMID: 1936070
• DOI: http://doi.org/10.3947/ic.2011.43.4.339

Abstract

BACKGROUND
Emphysematous pyelonephritis (EPN) is a severe gas-forming infection of renal parenchyma with high mortality and its adequate treatment modality remains controversial. There have been only a limited number of studies about EPN, particularly in Korea. Therefore, we present our experience in patients with EPN.
MATERIALS AND METHODS
Twenty-four patients that were diagnosed with EPN between January 1999 and June 2010 at a single medical center were retrospectively evaluated. Patient characteristics, causative pathogens, clinical features, complications, and mortality rates as modalities of managements and radiological classes of EPN were analyzed.
RESULTS
All of the 24 patients selected for the study were diabetic. Twenty-one patients were positive at urine culture and Escherichia coli (85.7%) was the predominant pathogen identified. Of the 24 patients, 17 were managed by broad-spectrum antibiotics and percutaneous renal drainage, whereas 7 were managed by direct nephrectomy. The total mortality rates were 12.5%, regardless of the modalities of management. The mortality rates were 12.5% in Class 3A and 40% in Class 3B, according to computed tomography (CT) findings.
CONCLUSIONS
Although conservative treatment included antibiotics, and percutaneous renal drainage offered an effective therapy for EPN, nephrectomy should be considered in patients with Class 3 EPN.

Keyword

Pyelonephritis; Percutaneous; Drainage

MeSH Terms

Anti-Bacterial Agents
Drainage
Escherichia coli
Humans
Korea
Nephrectomy
Pyelonephritis
Retrospective Studies
Anti-Bacterial Agents

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