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Am J Case Rep 2022 Jun 27;23:e936370. Epub 2022 Jun 27.

Department of Urology, Euromedik, Belgrade, Serbia.

BACKGROUND 0ptviral pneumonia and bilateral emphysematous pyelonephritis create a rapid acute respiratory distress syndrome. CASE REPORT A 59-year-old diabetic man with altered awareness was admitted as an emergency due to fever, shivering, and pain in the lap. Based on the accurate diagnosis, we concluded that the patient had bilateral emphysematous pyelonephritis, as well as inflammatory changes in the lung parenchyma caused by coronavirus infection (SARS-CoV-2). Read More

Ann Med Surg (Lond) 2022 Jun 4;78:103930. Epub 2022 Jun 4.

Urology Department La Rabta Hospital, Tunis, Tunisia.

Introduction: Emphysematous pyelonephritis (EPN) is a severe form of life-threatening renal infection. Conservative treatment represents the gold standard in the management of EPN, but nephrectomy remains appropriate in certain situations.

Objective: The aim of our study was to report our experience in the conservative management of emphysematous pyelonephritis and to identify the predictive factors of failure of conservative treatment. Read More

Acta Med Acad 2022 Apr;51(1):59-63

Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand. ORCID ID: https://orcid.org/0000-0002-0158-2685.

Objective: The aim of this case report is to illustrate a very rare case of emphysematous pyelonephritis complicated by IgAdominant postinfectious glomerulonephritis.

Case Report: We report the case of a 53-year-old woman with emphysematous pyelonephritis who initially presented with unintentional weight loss for 3 months and subnephrotic range proteinuria without fever. Urinalysis revealed proteinuria, microscopic hematuria, and pyuria. Read More

Cureus 2022 May 30;14(5):e25498. Epub 2022 May 30.

Medicine, SBH (St. Barnabas Hospital) Health System, New York City, USA.

Emphysematous pyelonephritis (EPN) is an acute life-threatening necrotizing infection of the renal parenchyma and perirenal tissues. There are multiple treatment strategies for EPN depending on the initial classification; over the last three decades, the treatment approach has favored kidney sparing strategies and the use of nephrectomy only as salvage therapy. We report a case involving a patient with unilateral emphysematous pyelonephritis complicated with hyperglycemic hyperosmolar state (HHS), sepsis, and multiple risk factors associated with poor prognosis who was successfully treated with conservative management sparing nephrectomy. Read More

World J Clin Cases 2022 Apr;10(10):3268-3277

Department of Emergency, Beijing Jishuitan Hospital, The Fourth Clinical Medical College of Peking University, Beijing 100035, China.

Background: Emphysematous pyelonephritis (EPN) is a severe acute necrotizing infection of the renal parenchyma and surrounding tissues that causes the presence of gas in the renal parenchyma, collecting system, or perinephric tissue and has a poor prognosis. EPN occurs primarily in people with diabetes mellitus (DM), but can occur in those without DM when the associated renoureteral unit is obstructed.

Case Summary: We describe our experience with six patients who developed EPN. Read More

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

Urol Case Rep 2022 Jul 5;43:102104. Epub 2022 May 5.

Urology Division, Surgery Department, University of Kinshasa, Democratic republic of Congo.

Authors report an emphysematous pyelonephritis case of bilateral urogenital lithiasis diseases on one hand, and on other, therapeutic approach through 38-year-old patient observation, non-diabetic, treated by percutaneous drainage in first intention, followed by a Nephro-ureterolithotomy and the right double J probe installation. Evolution post-treatment was satisfactory. Read More

J Vet Intern Med 2022 May 7;36(3):1005-1015. Epub 2022 May 7.

Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany.

Background: Immunosuppressive treatment with glucocorticoids and cyclosporine increases the risk for positive urine cultures (PUCs) in dogs.

Objective: To investigate the prevalence and incidence of PUC in dogs diagnosed with cancer and treated with antineoplastic chemotherapy while distinguishing between subclinical bacteriuria (SB) and urinary tract infection (UTI).

Animals: Forty-six client-owned dogs with nonurogenital cancer treated with antineoplastic chemotherapy. Read More

Urol Case Rep 2022 Jul 16;43:102086. Epub 2022 Apr 16.

University of Medical Center, 158, Sawgrass Drive, Second Floor, Rochester, NY 14620, USA.

Emphysematous pyelonephritis (EPN) developing in the contralateral kidney after ureteroscopic laser lithotripsy is an unusual clinical presentation and has never been reported in the literature. After ensuring sterile urine culture a 73-year-old female underwent left ureteroscopy, laser lithotripsy and stent placement for 15mm lower calyceal renal calculus. She was discharged same day and stent removed after 4 days. Read More

Asian J Urol 2022 Apr 5;9(2):146-151. Epub 2021 May 5.

Urology Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.

Objective: To describe the microbiological characteristics in emphysematous pyelonephritis (EPN), demonstrate the frequency of extended-spectrum beta-lactamase (ESBL) microorganisms, and determine if these microorganisms are associated with the prognosis of patients with EPN.

Methods: We conducted a retrospective study in patients with a diagnosis of EPN in a tertiary care hospital of the northeast region of Mexico during the period from January 2011 to January 2016. Clinical variables were analyzed to determine association with the presence of ESBL-producing microorganisms. Read More

Cureus 2022 Mar 28;14(3):e23579. Epub 2022 Mar 28.

Emergency Department, St. Barnabas Hospital (SBH) Health System, Bronx, USA.

Recognizing life-threatening infections is crucial for an emergency physician. In this case report, we describe an atypical presentation of a severe, infiltrating kidney infection, which, if not recognized early, could have led to a detrimental outcome. Emphysematous pyelitis, which is class I of emphysematous pyelonephritis, is a rare entity, and patients may present with a urinary tract infection or pyelonephritis. Read More

J Assoc Physicians India 2022 Apr;70(4):11-12

DY Patil Medical College and Hospital, Pimpri, chinchwad.

Diabetes mellitus (DM) is a clinical syndrome associated with deficiency of insulin secretion or action. It is considered one of the largest emerging threats to health in the 21st century. Besides the classical complications of the disease, DM has been associated with reduced response of T cells, neutrophil function, and disorders of humoral immunity. Read More

Am J Med Sci 2022 Apr 8. Epub 2022 Apr 8.

Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-er-qiao Road, Chengdu, Sichuan 610072, PR China. Electronic address:

Urol Case Rep 2022 Jul 25;43:102061. Epub 2022 Mar 25.

Urology and Kidney Transplant, Asian Institute of Medical Sciences, Faridabad, Haryana, India.

Mucormycosis is a rare disease. It is typically seen in immunocompromised patients. Isolated renal mucormycosis is an extremely rare disease. Read More

Sultan Qaboos Univ Med J 2022 Feb 28;22(1):113-116. Epub 2022 Feb 28.

Department of Nephrology, The Royal Hospital, Muscat, Oman.

Objectives: The recent drop in the mortality rates of emphysematous pyelonephritis, a serious medical condition, is attributable to renal percutaneous drainage (PCD) techniques that have also reduced the necessity for surgery. Since the difference in the objectives of the two specific techniques, i.e. Read More

Cureus 2022 Jan 25;14(1):e21612. Epub 2022 Jan 25.

Urology, New Jersey Urology, Voorhees, USA.

Fournier's gangrene and emphysematous pyelonephritis are rare necrotizing infections of the genitourinary system. Many cases of this rapidly progressive infection occur from abscesses and urinary tract infections; however, Fournier's gangrene secondary to emphysematous pyelonephritis is seldom discussed in the literature. Emphysematous pyelonephritis is defined as a gas-forming, necrotizing infection of the renal parenchyma or its surrounding tissue. 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

Urol Ann 2022 Jan-Mar;14(1):73-80. Epub 2022 Jan 20.

Department of Urology, Mahatma Gandhi Medical College, Puducherry, India.

Introduction: Even though the mortality rate in emphysematous pyelonephritis (EPN) is brought down presently to 13%-25%, there is still scope for improvement. The hurdle lies in identifying those patients at risk of mortality earlier in the disease process and providing intensive management to them. In this study, we created risk groups by combining both clinical and radiological presentations and applied a protocol-based treatment to evaluate its role in reducing mortality. 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.

Ann Med Surg (Lond) 2022 Feb 28;74:103281. Epub 2022 Jan 28.

Al-Moujtahed Hospital, Damascus, Syria.

Introduction: Emphysematous pyelonephritis is a rare necrotizing infection of the kidney. It should be diagnosed early because it has a bad prognosis. Treatments range from intravenous antibiotics to nephrectomy in severe cases. Read More

Actas Urol Esp (Engl Ed) 2022 Mar 2;46(2):98-105. Epub 2022 Feb 2.

Department of Urology, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico. Electronic address:

Introduction And Objectives: Emphysematous pyelonephritis is a life-threatening infection of the kidney and surrounding tissues associated with a high mortality rate. The aim of this study was to determine predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis, and to propose a therapeutic algorithm based on current literature and our experience.

Methods: A retrospective study was done including patients with emphysematous pyelonephritis in a single center in the north of Mexico from 2011 to 2016. Read More

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

Cureus 2021 Dec 27;13(12):e20766. Epub 2021 Dec 27.

Department of Radiology, University Hospital Sharjah, Sharjah, ARE.

We present a case of a 60-year-old male who presented with fever, shortness of breath, left upper quadrant pain accompanied by rigors and chills with a two-week history of productive cough. He had left upper quadrant tenderness and bilateral chest crepitations. The patient became tachypneic, dyspneic, and rapidly progressed to septic shock. Read More

Int Urol Nephrol 2022 Apr 1;54(4):717-736. Epub 2022 Feb 1.

Department of Urology, London North West University Healthcare NHS Trust, Watford Road, Harrow, London, HA1 3UJ, UK.

Purpose: Emphysematous pyelonephritis (EPN) is an acute, severe necrotising infection of the kidney. There has been a shift from early nephrectomy to conservative methods. We conducted a meta-analysis to assess the impact of risk factors and treatment choices on outcomes in EPN. Read More

Indian J Nephrol 2021 Nov-Dec;31(6):536-543. Epub 2021 Nov 9.

Department of Medicine, subdivision Nephrology, SRMS IMS Bareilly, Uttar Pradesh, India.

Introduction: Emphysematous pyelonephritis (EPN) is a necrotizing infection of the renal parenchyma. There is a lack of studies on follow up of EPN patients. The study aimed to explore the effect of EPN in patients with type 2 diabetes (T2D) on glycemic and renal parameters on follow up, and factors suggesting the failure of medical treatment. Read More

Zhonghua Wai Ke Za Zhi 2022 Feb;60(2):159-163

Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.

To examine the modalities of treatment and clinical outcomes of emphysematous pyelonephritis (EPN), in order to improve the survival rate of EPN patients. Totally 14 patients diagnosed as EPN between October 2011 and November 2020 at Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were included in this article. Data collection including patient demographics, clinical manifestations, management and clinical outcomes were conducted by retrospective charts review, after receiving the institutional review board's approval. Read More

Anaerobe 2022 Jan 4:102509. Epub 2022 Jan 4.

Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria.

Anaerobic cocci are common anaerobic isolates. Numerous genera of anaerobic cocci have been reported in both urinary tract microbiota, mainly of females, and in cases of urinary tract infections (UTIs), predominantly in patients with comorbidities, when no facultatively anaerobic bacteria were detected from the urine samples. UTIs caused by anaerobic cocci have been reported in >7% in some studies. Read More

Front Pediatr 2021 26;9:775468. Epub 2021 Nov 26.

Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

A 14-year-old girl noticed malodorous urine and experienced left flank pain. The patient was presented to our hospital with gradually increasing pain. She had no underlying disease but had a history of pain on micturition for several days. Read More

Urol Int 2021 Nov 30:1-8. Epub 2021 Nov 30.

Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Introduction: The aim of the study was to examine the efficacy of JJ stenting in comparison with percutaneous nephrostomy (PCN) as a drainage method in patients with emphysematous pyelonephritis (EPN).

Methods: We retrospectively identified patients with EPN between January 2000 and January 2021. Platelet-to-leukocytic ratio (PLR) at the time of hospital admission and discharge, time taken to clear air locules and to normalize leukocytic count, and air locule volume in mm3 were identified. Read More