Abstract
Emphysematous pyelonephritis (EPN) is a rare and ominous necrotizing kidney infection mainly involving diabetic patients. While prompt medical therapy with antibiotic and percutaneous catheter drainage is mainstay of management, nephrectomy should remain for unresponsiveness situations with poor prognostic factors. We introduced the clinical course of an old male presented with bilateral EPN which was successfully treated without nephrectomy regardless of various risk factors such as thrombocytopenia, impaired consciousness, and acute renal failure.
Highlights
Emphysematous pyelonephritis (EPN) is a life-threatening kidney and perinephric tissue infection, usually involving diabetic patients [1,2]
Nephrectomy should be maintained for the failure of conservative management
We report a case of bilateral EPN with adverse prognostic factors which successfully were handled by a non-surgical approach
Summary
Emphysematous pyelonephritis (EPN) is a life-threatening kidney and perinephric tissue infection, usually involving diabetic patients [1,2]. Case Presentation A 70-year-old male with type II diabetes and hypertension for 7 years was presented to emergency department with complaints of fever, abdominal pain, nausea, vomiting, urinary symptoms and oliguria. His past-medical history was only positive for dental surgery 1.5 years before this admission. After 36 days of hospitalization, the patient was discharged while kidney function was being recovered and he became dialysis free (Table 1). He had no fever with negative urine and blood culture. He is healthy and his serum creatinine is 1.4 mg/dL with a good glycemic control on oral hypoglycemic agents
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