Emphysematous pyelonephritis:Six case reports and review of literature  

作　　者：Li-Ping Ma Ning Zhou Yan Fu Yan Liu Cong Wang Bin Zhao 

机构地区：[1]Department of Emergency,Beijing Jishuitan Hospital,The Fourth Clinical Medical College of Peking University,Beijing 100035,China [2]Department of Urology Surgery,Beijing Jishuitan Hospital,The Fourth Clinical Medical College of Peking University,Beijing 100035,China

出　　处：《World Journal of Clinical Cases》2022年第10期3268-3277,共10页世界临床病例杂志

摘　　要：BACKGROUND Emphysematous pyelonephritis(EPN)is a severe acute necrotizing infection of the renal parenchyma and surrounding tissues that causes the presence of gas in the renal parenchyma,collecting system,or perinephric tissue and has a poor prognosis.EPN occurs primarily in people with diabetes mellitus(DM),but can occur in those without DM when the associated renoureteral unit is obstructed.CASE SUMMARY We describe our experience with six patients who developed EPN.Five patients had DM,including one with diabetic ketoacidosis,one with multisystem involvements,including eye,lung and brain.Bilateral urolithiasis was present in one case,along with emphysematous cystitis.Unilateral kidney stones were present in one patient.One patient was an older man in poor general health.Five individuals survived and underwent surgical procedures including ureteral stent installation(Double J stent placement),percutaneous nephrostomy and perinephric abscess puncture drainage,while one died because the patient’s family chose to terminate therapy.Klebsiella pneumoniae and Escherichia coli were the microorganisms implicated.CONCLUSION We conclude that EPN is a potentially fatal illness.A positive outcome necessitates early detection.Therapeutic measures should be implemented as soon as a diagnosis is made.

关 键 词：Emphysematous pyelonephritis Urinary tract infection CLASSIFICATION Gramnegative facultative anaerobic bacteria Case report 

分 类 号：R692.3[医药卫生—泌尿科学]