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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.

Saudi J Kidney Dis Transpl 2021 Jan-Feb;32(1):209-217

Department of Nephrology, Medanta- The Medicity, Gurgaon, Haryana, India.

A wide range of causative organisms can cause acute pyelonephritis (APN). However, in recent times, these pathogens have increasingly become resistant to most of the antibiotics making treatment difficult. This was a prospective observational single-center study with a aim to study the microbiological spectrum, resistance patterns, and clinical outcome of patients with APN conducted in a private tertiary care hospital in India. Read More

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

Curr Urol 2021 Mar 29;15(1):39-44. Epub 2021 Mar 29.

Department of Urology, Connolly Hospital, Blanchardstown, Dublin, Ireland.

Introduction: Sepsis is a life-threatening organ dysfunction that is caused by a dysregulated host response to the infection. Urosepsis contributes up to 25% of all sepsis cases. An important part of the management of urosepsis is to rule out possible surgical causes such as urolithiasis, obstructive uropathy, or abscess formation along the urogenital tract. 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

J Infect Chemother 2021 Aug 20;27(8):1131-1136. Epub 2021 May 20.

Department of Urology, Hyogo College of Medicine, Hyogo, Japan.

Patients with diabetes mellitus (DM) sometimes exhibited impaired immune function and aggravated infectious diseases. Urinary tract infection (UTI) is one of the major complications of DM. A systematic literature search was performed in PubMed and Cochrane Library using the following keywords: diabetes mellitus, urinary tract infection, asymptomatic bacteriuria, emphysematous pyelonephritis, emphysematous cystitis, renal papillary necrosis, and sodium-glucose co-transporter 2 (SGLT2) inhibitors. Read More

Urology 2021 May 17. Epub 2021 May 17.

Department of Urology, Vanderbilt University Medical Center, Nashville, TN.

Genitourinary infections are commonly encountered and managed in inpatient, outpatient, and emergency settings. Fournier's gangrene, emphysematous pyelonephritis, and obstructive pyelonephritis represent the most serious urologic infections and have a high risk of mortality if not managed promptly. Due to the rarity of these infections, the evidence for specific treatment strategies is scattered. Read More

Urol Case Rep 2021 Sep 29;38:101698. Epub 2021 Apr 29.

Department of Urology, Mohamed VI University Hospital Center, Mohamed I University, Oujda, Morocco.

Emphysematous pyelonephritis (EPN) on a single kidney is an extremely uncommon necrosing infection of renal parenchyma due often to infection by a gas-producing bacteria in a patient with uncontrolled diabetes mellitus. The management associate aggressive fluid and electrolyte resuscitation with several dialysis sessions, control of blood sugar levels, and broad-spectrum antibiotics with an urgent drainage. This paper aims to describe a case of a 68-year-old diabetic male patient who presented with EPN on a single kidney managed by conservative treatment. Read More

Afr J Lab Med 2021 26;10(1):1181. Epub 2021 Apr 26.

Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

Introduction: Emphysematous pyelonephritis is a life-threatening necrotising bacterial infection of the kidneys. It is rare among children and can be fatal if not promptly identified and treated.

Case Presentation: A 7-month-old male infant presented to the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, on 12 November 2019 with a 5-day history of fever and vomiting, and a 3-day history of a progressively enlarging, left-side abdominal mass. Read More

Urol Case Rep 2021 Sep 27;38:101685. Epub 2021 Apr 27.

Urology Department, King Saud Medical City, Riyadh, Saudi Arabia.

Emphysematous pyelonephritis (EPN) is a rare life-threatening gas producing kidney infection, commonly affects uncontrolled diabetic patients with underlying urinary tract obstruction. Presence of pneumoperitoneum and involvement of the bowels are uncommon presentation of EPN. In the present report, we present a 59-year-old African male who had extensive EPN with pneumoperitoneum, pneumatosis intestinalis and extension to the bowel causing ischemia. Read More

Nephrol Ther 2021 May 11. Epub 2021 May 11.

Service de médecine interne A, hôpital Charles-Nicolle, boulevard du 9 Avril, 1006 BS Tunis, Tunisie; Laboratoire de recherche d'immunologie de la transplantation rénale et d'immunopathologie (LR03SP01), hôpital Charles-Nicolle, boulevard du 9 Avril, 1006 BS Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunis, Tunisie.

Emphysematous pyelonephritis is a rare and severe infectious complication characterized by the presence of gas in the renal parenchyma, excretory cavities and surrounded tissues. It is due to the development of non-anaerobic gasifier bacteria. We report a new rare case of emphysematous pyelonephritis in a kidney transplant recipient, particular by its occurrence in a non-functional graft and its exceptional association with emphysematous cystitis. Read More

Urol Case Rep 2021 Sep 31;38:101663. Epub 2021 Mar 31.

Department of Urology, New York Medical College/Westchester Medical Center, Valhalla, NY, USA.

Emphysematous pyelonephritis is an acute necrotizing infection with gas in the kidney that portends a poor prognosis. Patients present with sepsis, requiring fluid resuscitation, glucose control, and broad-spectrum antibiotics. Surgical intervention ranges from relief of urinary obstruction (nephrostomy tube or stent), percutaneous drainage or nephrectomy. Read More

World J Clin Cases 2021 Apr;9(12):2862-2867

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

Background: Emphysema pyelonephritis (EPN) is a very dangerous type of urinary tract infection. It is a lethal disease that develops rapidly and causes the patient to deteriorate rapidly, and it can easily lead to systemic infections and even sepsis. The incidence is extremely low, and it is prevalent in patients with diabetes. Read More

Pediatr Nephrol 2021 May 6. Epub 2021 May 6.

Faculty of Medicine, Department of Pediatric Nephrology and Rheumatology, Katip Celebi University, İzmir, Turkey.

Front Med (Lausanne) 2021 9;8:658682. Epub 2021 Apr 9.

Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kawasaki, Japan.

Type 2 diabetes mellitus (T2DM) is often accompanied by a lot of complications due to chronic hyperglycemia and inflammation. Emphysematous cystitis and pyelonephritis are rare types of urinary tract infections and are often complicated with DM. Herein, we report a case of emphysematous cystitis and pyelonephritis complicated with untreated DM. 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

Indian J Urol 2021 Jan-Mar;37(1):97-98. Epub 2021 Jan 1.

Department of Urology, AIIMS, Rishikesh, Uttarakhand, India.

Emphysematous pyelonephritis (EPN) is a life-threatening infection of kidney with the presence of gas in the renal parenchyma, collecting system, and the surrounding retroperitoneum. We present a case of EPN in a diabetic patient with extension of gas into the spinal epidural space of the lumbar vertebral canal. He was managed conservatively with minimally invasive intervention along with supportive medical management and recovered well. Read More

Cureus 2021 Feb 23;13(2):e13513. Epub 2021 Feb 23.

Radiology, Dr. Ajmera Diagnostic, New Delhi, IND.

Gas forming infections of the renal collecting system occurs because of organisms like Escherichia coli, Klebsiella, and Proteus. If the gas is restricted to the collecting system, without causing involvement of the cortex, it is called emphysematous pyelitis; whereas, invasion and penetration of the cortex imply a more gruesome diagnosis of emphysematous pyelonephritis. A 59-year-old male patient, previously diagnosed with a large right renal calculus and having multiple co-morbidities presented to the surgery department with right flank pain; Double J (DJ) stenting was done to relieve the pain from colic due to obstructive renal calculi; the patient subsequently discharged without any post-procedural complications. Read More

J Ayub Med Coll Abbottabad 2021 Jan-Mar;33(1):162-164

Department of Urology and Kidney Transplant, Pakistan Kidney and Liver Institute, Lahore Pakistan.

Emphysematous pyelonephritis (EPN) is a type of critical renal infection having dire consequences at times. It is said to be result of gases produced inside renal parenchymal tissue or pelvicalyceal system. Rarely coexistence of emphysematous pyelonephritis and emphysematous cystitis (EC) may lead to an intimidating condition in case it is not dealt with swiftly. 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 Mar;127(3):300-303

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

Clin Pract Cases Emerg Med 2021 Feb;5(1):35-38

University of California, Irvine, Department of Emergency Medicine, Orange, California.

Introduction: Point-of-care ultrasound (POCUS) in the emergency department (ED) is being performed with increasing frequency. The objective of this study was to demonstrate how utilization of POCUS can help the emergency physician recognize emphysematous pyelitis (EP) and emphysematous pyelonephritis (EPN).

Case Report: A 60-year-old female presented to the ED with normal vital signs and intermittent left-sided flank pain that radiated to her groin. Read More

J Diabetes Metab Disord 2020 Dec 28;19(2):1273-1282. Epub 2020 Sep 28.

Department of Microbiology, Govt. Medical College, Srinagar, J&K India.

Purpose: Emphysematous pyelonephritis (EPN) patients with type 2 diabetes (T2D) have severe complications and high morbidity with poor prognosis as compared to Pyelonephritis. The aim was to study clinical features, microbiological profile, complications of EPN and pyelonephritis in T2D patients.

Methods: This was a hospital-based prospective study done on 200 T2D patients with upper UTI. Read More

IDCases 2021 14;23:e01042. Epub 2021 Jan 14.

University of Toledo, Division of Infectious Diseases, United States.

A 57-year-old man presenting with bilateral flank pain and hematuria was found to have severe bilateral emphysematous pyelonephritis. The patient was managed with a conservative approach consisting of systemic antimicrobials and decompression via percutaneous nephrostomy tubes with piperacillin-tazobactam instillations via nephrostomy and made a full recovery. Read More

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