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ISRN Urology
Volume 2012 (2012), Article ID 931982, 4 pages
http://dx.doi.org/10.5402/2012/931982
Clinical Study

Clinical Profile and Outcome of Conservatively Managed Emphysematous Pyelonephritis

1Department of Nephrology, Narayana Medical College Hospital, Chinthareddypalem, Andhra Pradesh, Nellore 524002, India
2Department of Radiology, Narayana Medical College Hospital, Chinthareddypalem, Andhra Pradesh, Nellore 524002, India
3Department of Clinical Pharmacology, Narayana Medical College Hospital, Chinthareddypalem, Andhra Pradesh, Nellore 524002, India

Received 14 December 2011; Accepted 11 January 2012

Academic Editors: K. Naber and G. J. Wise

Copyright © 2012 Praveen Kumar Kolla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Emphysematous pyelonephritis (EPN) is a severe, necrotizing renal parenchymal infection characterized by production of intraparenchymal gas. EPN predominantly affects female diabetics and immunocompromised patients. In a three-year period 2008–2011, a total of 8 patients were admitted to our hospital. All of them were diabetics, and both males and females were equally affected. These patients showed vague symptoms at admission and frequently presented with fever, loin pain, dysuria, and pyuria necessitating urgent medical attention. EPN required radiological diagnosis. CT scan revealed bilateral EPN with urinary obstruction and hydronephrosis in 50% of patients. Escherichia coli was found to be the causative organism in all the patients. Treatment comprised of resuscitation, normalization of serum electrolytes and blood sugars, administration of parenteral antibiotics, and relieving ureteric obstruction if present. All the patients improved with conservative management without any mortality.