Authors:
Erden Erol Ünlüer Izmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey

Search for other papers by Erden Erol Ünlüer in
Current site
Google Scholar
PubMed
Close
,
Yusuf Şahin Izmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey

Search for other papers by Yusuf Şahin in
Current site
Google Scholar
PubMed
Close
,
Orhan Oyar İzmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey

Search for other papers by Orhan Oyar in
Current site
Google Scholar
PubMed
Close
,
Gözde Canan Tan Izmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey

Search for other papers by Gözde Canan Tan in
Current site
Google Scholar
PubMed
Close
,
Arif Karagöz İzmir Karşıyaka State Hospital, İzmir, Turkey

Search for other papers by Arif Karagöz in
Current site
Google Scholar
PubMed
Close
, and
Celaleddin Turan İzmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey

Search for other papers by Celaleddin Turan in
Current site
Google Scholar
PubMed
Close
Open access

Emphysematous pyelonephritis (EP) is a rare form of necrotizing pyelonephritis. It is a life-threatening condition that usually affects patients with diabetes, and a small percentage may be due to urinary tract obstruction. Here, we present the case of an EP caused by urinary tract obstruction without diabetes. A 45-year-old woman presented to the emergency department with fever, chills, and abdominal pain. There was no significant past history. Physical examination depicted bilateral lower abdominal and right flank knocking tenderness. Laboratory exams revealed leukocytosis, neutrophilia, a high C-reactive protein level, and pyuria. Abdominal computerized tomography (CT) showed diffuse gas in the right renal collecting system and dilatation of the right renal pelvis compared to the right side, in addition to multiple millimetric stones located in the right kidney and right ureter. After emergent placement of a percutaneous nephrostomy, she was admitted. Control abdominal CT without contrast revealed the absence of gas, hydronephrosis of the right renal pelvis, and the presence of nephrolithiasis. The patient was discharged 10 days of post-procedure with instructions for follow-up. Emergency physicians need to remain alert about this life-threatening disease and the typical CT findings of this disease to make a timely diagnosis and navigate management.

  • 1.

    Shokeir AA , El-Azab M, Mohsen T, El-Diasty T: Emphysematous pyelonephritis: a 15-year experience with 20 cases. Urology 49, 44874488 (1997)

    • Search Google Scholar
    • Export Citation
  • 2.

    Huang JJ , Tseng CC: Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis, and pathogenesis. Arch Intern Med 160, 44874488 (2000)

    • Search Google Scholar
    • Export Citation
  • 3.

    Michaeli J , Mogle P, Perlberg S, Heiman S, Caine M: Emphysematous pyelonephritis. J Urol 131, 44874488 (1984)

  • 4.

    Kelly HA , MacCallum WG: Pneumaturia. JAMA 31, 44874488 (1898)

  • 5.

    Ouellet LM , Brook MP: Emphysematous pyelonephritis: an emergency indication for the plain abdominal radiograph. Ann Emerg Med 17, 44874488 (1988)

    • Search Google Scholar
    • Export Citation
  • 6.

    Evanoff GV , Thompson CS, Foley R, Weinman EJ: Spectrum of gas within the kidney. Emphysematous pyelonephritis and emphysematous pyelitis. Am J Med 83, 44874488 (1987)

    • Search Google Scholar
    • Export Citation
  • 7.

    Chen KW , Huang JJ, Wu MH, Lin XZ, Chen CY, Ruaan MK: Gas in hepatic veins: a rare and critical presentation of emphysematous pyelonephritis. J Urol 151, 44874488 (1994)

    • Search Google Scholar
    • Export Citation
  • 8.

    Tseng CC , Wu JJ, Wang MC, Hor LI, Ko YH, Huang JJ: Host and bacterial virulence factors predisposing to emphysematous pyelonephritis. Am J Kidney Dis 46, 44874488 (2005)

    • Search Google Scholar
    • Export Citation
  • 9.

    Cook DJ , Achong MR, Dobranowski J: Emphysematous pyelonephritis. Complicated urinary tract infection in diabetes. Diabetes Care 12, 44874488 (1989)

    • Search Google Scholar
    • Export Citation
  • 10.

    Andersen JB : Pyelonephritis emphysematosa. En alvorlig komplikation til diabetes mellitus. Ugeskr Laeger 154, 44874488 (1992)

  • 11.

    Wang JM , Lim HK, Pang KK: Emphysematous pyelonephritis. Scand J Urol Nephrol 41, 44874488 (2007)

  • 12.

    Sandler CM , Amis ES Jr, Bigongiari LR, Bluth EI, Bush WH Jr, Choyke PL, Fritzsche P, Holder L, Newhouse JH, Segal AJ, Resnick MI, Rutsky EA: Imaging in acute pyelonephritis. American College of Radiology. ACR Appropriateness Criteria. Radiology 215, 44874488 (2000)

    • Search Google Scholar
    • Export Citation
  • Collapse
  • Expand

2019  
Scimago
H-index
11
Scimago
Journal Rank
0,220
Scimago
Quartile Score
Medicine (miscellaneous) Q3
Scopus
Cite Score
155/133=1,2
Scopus
Cite Score Rank
General Medicine 199/529 (Q2)
Scopus
SNIP
0,343
Scopus
Cites
206
Scopus
Documents
23

 

Interventional Medicine and Applied Science
Language English
Size  
Year of
Foundation
2009
Publication
Programme
changed title
Volumes
per Year
 
Issues
per Year
 
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2061-1617 (Print)
ISSN 2061-5094 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Nov 2023 0 11 1
Dec 2023 0 20 0
Jan 2024 0 18 3
Feb 2024 0 9 2
Mar 2024 0 10 8
Apr 2024 0 30 1
May 2024 0 0 0