Korean J Nephrol.
1999 Mar;18(2):348-352.
A Case of Emphysematous Pyelonephritis in Which Intrarenal Gas Persistently Appeared over 1 month: Experience of Successful Management by Medical Treatment
- Affiliations
-
- 1Department of Internal Medicine, Medical College, The Catholic University of Korea, Seoul, Korea.
Abstract
-
Emphysematous pyelonephritis is an uncommon and life-threatening necrotizing infection of the
renal parenchyma that requires prompt diagnosis and early treatment. It is associated with
gas-forming coliform bacteria, and is characterized by the presence of gas within the renal
parenchyma. The clinical picture and gas pattern should be monitored carefully before a
surgical desion is made. If there is persistence of gas on serial x-rays despite aggressive
therapy, prompt surgical therapy is recommended. We herein present 1 diabetic patient with
emphysematous pyelonephritis who responded to medical treatment alone. The presence of gas
was confirmed by CT scan and Escherchia coli was isolated in both urine and blood cultures.
The patient was treated with antibiotics alone. Although the clinical signs and laboratory
findings were improved, intrarenal gas persistently appeared over 1 month. CT scan 2 month
after medical treatment revealed absence of gas in the renal parenchyma.