A near-fatal case of emphysematous pyelonephritis: Embracing the new management 'gold standard' – Saving the life while saving the kidney!

A. Adam, K. Spencer
2017 African Journal of Urology  
Emphysematous pyelonephritis (EPN) is a rare, acute, severe infection of the renal parenchyma and its surrounding tissues and is associated with a significant morbidity and mortality. Underlying diabetes is the most commonly associated risk factor. Observation: We report on the presence of EPN (Grade 3a) in a patient with poorly controlled diabetes, who presented in septic shock due to EPN. Although previous older treatment algorithms would proceed with an immediate nephrectomy, based on her
more » ... my, based on her grade, she was successfully managed by incorporating the new treatment 'gold standard': medical management with percutaneous drainage. A high index of suspicion is required to detect and manage this life-threatening condition associated with diabetes, since the presenting symptoms may be non-specific. The diagnosis, risk factors, and current management options of EPN are expanded further.
doi:10.1016/j.afju.2016.08.003 fatcat:bivtmiy6kfghnk7z2aglhn2dcy