Massive bilateral grade IV emphysematous pyelonephritis: Case report.

Autor:	Martínez CAP; Department of Internal Medicine, Regional General Hospital Num. 72 'Lic. Vicente Santos Guajardo', Mexican Social Security Institute, Tlalnepantla de Baz, State of Mexico, Mexico., Barajas IGR; Department of Internal Medicine, Regional General Hospital Num. 72 'Lic. Vicente Santos Guajardo', Mexican Social Security Institute, Tlalnepantla de Baz, State of Mexico, Mexico., Jeréz MFC; Department of Internal Medicine, Regional General Hospital Num. 72 'Lic. Vicente Santos Guajardo', Mexican Social Security Institute, Tlalnepantla de Baz, State of Mexico, Mexico., González BL; Department of Internal Medicine, Regional General Hospital Num. 72 'Lic. Vicente Santos Guajardo', Mexican Social Security Institute, Tlalnepantla de Baz, State of Mexico, Mexico., Porras LJR; Department of General Surgery, High Specialty Regional Hospital 'Bicentenario de la independencia', Institute for Social Security and Services for State Workers, Tultitlan de mariano escobedo, State of México, Mexico., Fierro LAG; Department of Internal Medicine, General Hospital Ajusco Medio, Secretary of Health of Mexico City, Mexico City, Mexico., Sánchez ER; Department of Internal Medicine, Regional General Hospital Num. 72 'Lic. Vicente Santos Guajardo', Mexican Social Security Institute, Tlalnepantla de Baz, State of Mexico, Mexico.
Jazyk:	angličtina
Zdroj:	IDCases [IDCases] 2022 Nov 23; Vol. 30, pp. e01646. Date of Electronic Publication: 2022 Nov 23 (Print Publication: 2022).
DOI:	10.1016/j.idcr.2022.e01646
Abstrakt:	Emphysematous pyelonephritis (EPN) is a severe disease of the renal system in which gas formed by facultative anaerobe microorganisms accumulates, being Escherichia coli the most representative causative agent. A series of conditions foster its development including uncontrolled diabetes mellitus, diabetic nephropathy and obstructive uropathy. Abdominal CT scan continues to be the gold standard for diagnosis. Currently, nephrectomy is avoided as much as possible, and more conservative treatments are given. Mortality is still as high as 21 % despite new therapeutic options, all of which are mostly surgical. The rarest cases are those classified as grade IV, which affect both kidneys; these are considered the most lethal of the clinical presentations and they are also of particular interest, since a multidisciplinary team must be in charge of treatment. Herein, we present the case of an elderly woman with chronic diseases and a presentation of massive emphysematous pyelonephritis concurrent with emphysematous cystitis and pneumoperitoneum, who required bilateral radical nephrectomy despite efforts of preserving at least one of the kidneys. Competing Interests: We declare that there are no conflicts of interest amongst the authors.
Databáze:	MEDLINE
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