Emphysematous Pyelonephritis

Kwon, Dong Ouk; Chang, Sung Goo

Abstract

Emphysematous pyelonephritis is a rare, life endangering suppurative infection characterized by the production of intrarenal and occasionally perirenal gas which generally occurs in patient with diabetes mellitus or urinary tract obstruction. Clinically, it appears as an acute severe clinical pyelonephritis that needs emergency care with poor prognosis. Recently, we experienced six cases of emphysematous pyelonephritis, so a clinical study was made on these six patients who were admitted to the Department of Urology, Kyung Hee University from April 1986 to June 1987. The results were as followings : 1. Four patients were female and 2 were male, age distribution ranged from 31 to 72 years. All patients had diabetes mellitus and duration of diabetes mellitus ranged from 8 months to 10 years. 2. Causative organism were E. coli in 5 patients, and Mucormycosis in 1 patient who had alcoholism and septic pneumonia. 3. the disease involved right kidney in 3 patients, the left kidney in 3 patients. Bilateral emphysematous pyelonephritis was not found. 4. Simple abdominal radiography and renal sonogram were performed in 6 patients to identify the gas in renal area. Computerized tomography were used to localize the gas and extent of infection, in 4 patients. Intraparenchymal gas only was found in 1 patient, gas in renal parenchyme and perineral space was found in 5 patients. 5 3 patients were treated by conservative management and other 3 patients underwent nephrectomy. 2 patients were expired, one is treated by nephrectomy and another by conservative ma-nagement each other. 4 patients survived.