Nonsurgical Management of Emphysematous Pyelonephritis: a short report of four cases

  • سال انتشار: 1398
  • محل انتشار: مجله دانشگاه علوم پزشکی کرمان، دوره: 26، شماره: 3
  • کد COI اختصاصی: JR_JKMU-26-3_009
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 157
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نویسندگان

Mahboubeh Mirzaei

Assistant Professor, Department of Urology, Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

Mohammadreza Ebadzadeh

Assistant Professor, Department of Urology, Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

Ali Kamalati

Assistant Professor, Department of Urology, Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

Rayka Sharifian

Urologist, Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

Azar Daneshpajooh

Assistant Professor, Department of Urology, Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

چکیده

Emphysematous pyelonephritis (EPN) is an acute necrotizing and suppurative infection of the kidney parenchyma. It is defined by the presence of gas within the kidney parenchyma and surrounding tissues. This rare condition is usually seen in diabetic or immunocompromised adults. In this paper, we report four cases of emphysematous pyelonephritis (including two diabetic patients) managed by broad spectrum antibiotics and drainage. These patients were in different clinical stages of the disease (۱, ۲, ۳a, and ۴). All of them were discharged after a mean hospital stay of two to three weeks without needing a major surgery. Patients with kidney stone were referred to an endo-urologist for percutaneous nephrolitotomy after hospital discharge. We managed our four cases conservatively with an aggressive medical treatment including rapid control of dehydration, high blood glucose level (for diabetic cases), hypoxia, sepsis and kidney failure. The results were promising. Thus, we believe that in EPN patients, nephrectomy can be replaced by conservative therapy.

کلیدواژه ها

Emphysematous pyelonephritis, Computed Tomography, Percutaneous intervention

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