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Ann R Coll Surg Engl 2022 May 26. Epub 2022 May 26.

Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Introduction: Emphysematous pyelonephritis (EPN) is a deadly disease due to its associated morbidity and mortality. Attempts have been made to identify predictors of severity, mortality and need for nephrectomy in EPN with little success.

Methods: We conducted an ambispective study of EPN patients between March 2014 and September 2019. Read More

Ther Adv Urol 2022 Jan-Dec;14:17562872221078773. Epub 2022 Feb 22.

Department of Radiology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, India.

Introduction: Emphysematous pyelonephritis (EPN), an acute necrotizing infection of the kidney and surrounding tissues, is associated with considerable mortality. We evaluated how existing critical care scoring systems could predict the need for intensive care unit (ICU) management for these patients. We also analyzed if CT-imaging further enhances these predictive systems. Read More

Transpl Infect Dis 2022 04 28;24(2):e13807. Epub 2022 Feb 28.

Department of Kidney Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

BMJ Case Rep 2022 Feb 3;15(2). Epub 2022 Feb 3.

Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA.

A 15-year-old female adolescent with a medical history of recurrent urinary tract infections and grade 1 left-sided vesicoureteral reflux presented to the emergency room with abdominal and back pain. Labs revealed a haemoglobin A1c (HbA1c) of 9.1% and a random blood glucose of 200 mg/dL, consistent with new-onset diabetes mellitus. Read More

Caspian J Intern Med 2021 ;12(Suppl 2):S505-S508

Department of Urology, Babol University of Medical Sciences, Babol, Iran.

Background: Xanthogranulomatous pyelonephritis (XGP) is a rare and intense type of chronic kidney infection characterized by subversion of the renal tissue and its replacement by lipid- laden macrophages. XGP combined with emphysematous pyelonephritis(EPN) is rare and up until now only 7 cases with these presentations have been reported; so abundant clinical skills and appropriate radiographic imaging is required to reach the correct diagnosis. In this report, we present a case with two uncommon variants of pyelonephritis. Read More

Urol Case Rep 2022 Jan 12;40:101895. Epub 2021 Oct 12.

Department of Urology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA.

Emphysematous pyelonephritis is a severe and rare gas producing infection in the renal parenchyma or collecting system. Diabetes mellitus is an established risk factor. Treatment options include antibiotics, minimally invasive management such as percutaneous drainage, or nephrectomy. Read More

Hinyokika Kiyo 2021 Aug;67(8):373-379

The Department of Urology, Matsusaka City Hospital.

A 68-year-old man sought evaluation at our emergency department in the early morning of day X with a feverfor3 days. The physical examination revealed pain in the left back, and an abdominal computed tomography (CT) showed a high density of fatty tissue around the left kidney. With a diagnosis of left acute bacterial pyelonephritis, he was hospitalized, antibacterial drug treatment was started, and he was transferred to our department on the same day. Read More

Urol Ann 2021 Jul-Sep;13(3):277-281. Epub 2021 May 28.

Department of Urology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India.

Context: Developing countries.

Introduction: Emphysematous pyelonephritis (EPN) is a urologic emergency characterized by acute necrotizing infection with the presence of gas in the kidney, perinephric space, and/or urinary collecting system.

Materials And Methods: It is a retrospective study of inpatients at the Department of Urology, RG Kar Medical College and Hospital, Kolkata, which includes twenty patients diagnosed as EPN between September of 2018 and May of 2020. Read More

J Pediatr Urol 2021 Oct 27;17(5):738.e1-738.e5. Epub 2021 Jul 27.

Department of Pediatric Nephrology, University of Health Sciences Dr. Behc¸et Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey. Electronic address:

Introduction: Imaging of the urinary tract by ultrasonography (USG) or computerized tomography scanning is recommended for detecting structural abnormalities, hydronephrosis, abscesses, emphysematous pyelonephritis, or fungus ball formation. Limited studies on the epidemiology and the imaging results of candiduria were present in the children.

Aim: This study aimed to evaluate the results of renal ultrasonography imaging in hospitalized pediatric patients with candiduria. Read More

J Postgrad Med 2021 Jul-Sep;67(3):146-153

Department of Urology, Grant Government Medical College & Sir JJ Hospital, Mumbai, Maharashtra, India.

Context: Emphysematous pyelonephritis (EPN) is a dangerous necrotizing infection of the kidney involving the diabetics with a high case fatality rate. Recent medical literature has shown shifting of treatment strategy from conventional radical approach to minimally invasive approach.

Aims: The aim of our study was to assess the role of minimally invasive stepwise decompression techniques in the management of EPN and preservation of the renal unit. Read More

BMJ Case Rep 2021 Aug 11;14(8). Epub 2021 Aug 11.

Endocrinology, Naas General Hospital, Naas, Kildare, Ireland.

A 49-year-old woman presented to the emergency department acutely unwell. Initial investigations revealed hyperglycaemia, ketosis and an acute kidney injury precipitated by urosepsis. She was found to have a new diagnosis of diabetes mellitus (type 2) with a glycated haemoglobin (HbA1c) of 156 mmol/mol. Read More

BMJ Case Rep 2021 Jul 21;14(7). Epub 2021 Jul 21.

Gastroenterology and Hepatology, Mayo Clinic Minnesota, Rochester, Minnesota, USA.

Asian J Surg 2021 Sep 26;44(9):1234-1235. Epub 2021 Jun 26.

Department of Surgery, The University of Hong Kong - Shenzhen Hospital, Shenzhen, 518053, Guangdong, China.

Intern Med J 2021 06;51(6):995-996

Department of Nephrology, John Hunter Hospital, Newcastle, New South Wales, Australia.

Saudi J Kidney Dis Transpl 2021 Jan-Feb;32(1):286-288

Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.

Medicina (B Aires) 2021 ;81(3):482

Servicio de Cirugía General y Gastroenterología, Instituto de Enfermedades Digestivas, Córdoba, República Argentina.

Hinyokika Kiyo 2021 Apr;67(4):147-152

The Department of Urology, Muroran City General Hospital.

We report a rare case of necrotizing fasciitis in the thigh induced by emphysematous pyelonephritis due to a staghorn stone. A 60-year-old female was diagnosed with a staghorn stone in the right kidney at another clinic. We referred her to another hospital for indication of percutaneous nephrolithotripsy. Read More

Medicina (Kaunas) 2021 May 26;57(6). Epub 2021 May 26.

Department of Urology, College of Medicine, Kyung Hee University, Seoul 02447, Korea.

To investigate the risk factors for emphysematous cystitis (EC) compared to those of acute cystitis (AC) to increase clinicians awareness of the possibility for the aggravation of patient status. We retrospectively reviewed a total of 54 patients who were hospitalized with a diagnosis of EC by abdominal computed tomography (CT) scan from 2006 to 2020. The control group included 92 patients who were hospitalized for the treatment of AC in the same period. Read More

World J Clin Cases 2021 Apr;9(11):2584-2594

Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China.

Background: Emphysematous pyelonephritis (EPN) is a rare but fatal necrotic infection of the kidney, which usually leads to septic shock. Therefore, early diagnosis and optimized therapy are of paramount importance. In the past two decades, point-of-care ultrasound (POCUS) has been widely used in clinical practice, especially in emergency and critical care settings, and helps to rapidly identify the source of infection in sepsis. Read More

J R Coll Physicians Edinb 2021 03;51(1):19-23

Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh.

Background: Emphysematous pyelonephritis (EPN) is a necrotizing infection of the renal parenchyma, collecting system and/or perinephric tissues, characterized by gas accumulation. We describe clinical, laboratory and imaging characteristics and in-hospital outcomes of patients with EPN.

Methods: This retrospective observational study was carried out at BIRDEM General Hospital, Dhaka, Bangladesh between 2014 and 2020. Read More

J Bras Nefrol 2021 Mar 24. Epub 2021 Mar 24.

Universidade Estadual do Oeste do Paraná (Unioeste), Centro de Ciências Médicas e Farmacêuticas (CCMF), Hospital Universitário do Oeste do Paraná (HUOP), Cascavel, PR, Brasil.

Emphysematous pyelonephritis (EPN) is a rare acute necrotizing infection of the kidney and surrounding tissues, with gas in the renal parenchyma, collecting system or perirenal tissue. The bacterial etiology predominates; mainly Gram-negative bacilli; Candida spp. and C. Read More

BMJ Case Rep 2021 Feb 26;14(2). Epub 2021 Feb 26.

Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA

BJU Int 2021 03;127(3):300-303

Department of Urology, University of Michigan, Ann Arbor, MI, USA.

J Endourol Case Rep 2020 29;6(4):445-447. Epub 2020 Dec 29.

College of Medicine and Health Sciences, United Arab Emirates University and Mediclinic Al Ain, Al Ain, United Arab Emirates.

The presence of intra-calcular gas might indicate the coexistence of gas-forming bacterial infections, which are potentially severe and life threatening. Gas-containing renal stones are rare. Herein, we present a case of gas-containing renal matrix stone that was associated with emphysematous pyelitis and reflect on its management. Read More

AJR Am J Roentgenol 2021 03 13;216(3):812-823. Epub 2021 Jan 13.

Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH.

The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement. Read More

Trop Doct 2021 Jul 7;51(3):452-454. Epub 2021 Jan 7.

Professor, Department of Nephrology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh.

Emphysematous pyelonephritis is a rare, severe form of necrotising infection of the kidneys and peri-nephric tissues with gas accumulation, occurring predominantly among patients with diabetes mellitus. Computed tomography scan can identify the distribution of gas in the affected reno-ureteral units and so establish and classify the diagnosis. We report a case of class 4 emphysematous pyelonephritis with emphysematous cystitis, occurring in a young Bangladeshi male, who presented with features of upper urinary tract infection. Read More

Medicina (Kaunas) 2021 Jan 1;57(1). Epub 2021 Jan 1.

Radiology department, Urology and Nephrology Center, Mansoura University, 35516 Mansoura, Egypt.

There are many acute and chronic infections affecting the urinary tract including bacterial, fungal and viral infections. Urinary tract infections (UTIs) can present in many different patterns with variable degrees of severity varying from asymptomatic and uncomplicated forms to life threatening complicated infections. Cross-sectional imaging techniques-including both computed tomography (CT) and magnetic resonance imaging (MRI)-have become very important tools not only for evaluation of UTIs, but also for detection of associated complications. Read More

PLoS One 2020 31;15(12):e0244870. Epub 2020 Dec 31.

Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Objective: Previous studies on diagnostic accuracy of dipstick testing for leukocyte esterase (LE) and nitrite to diagnose urinary tract infection (UTI) had used urine culture, which is an imperfect gold standard. Estimates of diagnostic accuracy obtained using the classical gold standard framework might not reflect the true diagnostic accuracy of dipstick tests.

Methods: We used the dataset from a prospective, observational study conducted in the emergency department of a teaching hospital in southern India. Read More

Urologiia 2020 12(6):118-121

Department and Clinic of General Surgery of FGBVOU VO S. M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia.

Emphysematous pyelonephritis is rare form of pyelonephritis, which has mortality of nearly 80%. Conservative treatment can be successful in less than 30% of cases. Currently, in the guidelines there is no standard approach to conservative and surgical treatment of this entity. Read More

Medicina (B Aires) 2020 ;80(6):703

Servicio de Clínica Médica, Sanatorio Güemes, Buenos Aires, Argentina.