Advertisement

International Urology and Nephrology

, Volume 46, Issue 1, pp 223–227 | Cite as

Medical therapy alone can be sufficient for bilateral emphysematous pyelonephritis: report of a new case and review of previous experiences

  • Mohammad Shafi Kuchay
  • Bashir Ahmad Laway
  • Manzoor Ahmad Bhat
  • Shahnaz Ahmad Mir
Nephrology - Case report

Abstract

Bilateral emphysematous pyelonephritis (EPN) is an extremely uncommon, life-threatening gas-forming infection of renal parenchyma and its surrounding areas. Surgical treatment, including percutaneous catheter drainage and nephrectomy, has been advocated as the treatment of choice in most of the patients. However, nephrectomy is itself a hazardous intervention in an unstable septic patient. Whenever bilateral disease is present, the need for long-term renal replacement therapy is unavoidable. We present the clinical course of a lady who presented with bilateral EPN and was successfully managed by medical therapy alone. We also reviewed almost all published cases of bilateral EPN that had been managed medically.

Keywords

Bilateral emphysematous pyelonephritis Gas-forming infection Medical management 

Notes

Conflict of interest

No conflict of interests.

References

  1. 1.
    Asgari SA (2004) Successful medical treatment of emphysematous pyelonephritis. Urol J 1:282–283PubMedGoogle Scholar
  2. 2.
    Huang JJ, Tseng CC (2000) Emphysematous pyelonephritis clinicoradiological classification, management, prognosis and pathogenesis. Arch Intern Med 160:797–805PubMedCrossRefGoogle Scholar
  3. 3.
    Shigemura K, Yasufuku T, Yamashita M, Arakawa S, Fujisawa M (2009) Bilateral emphysematous pyelonephritis cured by antibiotics alone: a case and literature review. Jpn J Infect Dis 62:206–208PubMedGoogle Scholar
  4. 4.
    Naggapan R, Kletchko S (1992) Bilateral emphysematous pyelonephritis resolving to medical therapy. J Intern Med 232:77–80CrossRefGoogle Scholar
  5. 5.
    George J, Chakravarthy S, John GT, Jacob CK (1995) Bilateral emphysematous pyelonephritis responding to nonsurgical management. Am J Nephrol 15:172–174PubMedCrossRefGoogle Scholar
  6. 6.
    Angulo JC, Dehaini A, Escribano J et al (1997) Successful conservative management of emphysematous pyelonephritis, bilateral or in a solitary kidney. Scand J Urol Nephrol 31:193–197PubMedCrossRefGoogle Scholar
  7. 7.
    Shimizu H, Hariu K, Kamiyama Y et al (1999) Bilateral emphysematous pyelonephritis with autosomal-dominant polycystic kidney disease successfully treated by conservative method. Urol Int 63:252–254PubMedCrossRefGoogle Scholar
  8. 8.
    Arun N, Hussain A, Kapoor MM, Abul F (2007) Bilateral emphysematous pyelonephritis and emphysematous cystitis with autosomal-dominant polycystic kidney disease: is conservative management justified? Med Prince Pract 16:155–157CrossRefGoogle Scholar
  9. 9.
    Grozel F, Berthezene Y, Guerin C et al (1997) Bilateral emphysematous pyelonephritis resolving to medical therapy: demonstration by US and CT. Eur Radiol 7:844–846PubMedCrossRefGoogle Scholar
  10. 10.
    Hildebrand TS, Nibbe L, Frei U, Schindler R (1999) Bilateral emphysematous pyelonephritis caused by Candida infection. Am J Kidney Dis 33:E10PubMedCrossRefGoogle Scholar
  11. 11.
    Tahir H, Thomas G, Sheerin N, Bettington H, Pattison JM, Goldsmith DJ (2000) Successful medical treatment of acute bilateral emphysematous pyelonephritis. Am J Kidney Dis 36:1267–1270PubMedCrossRefGoogle Scholar
  12. 12.
    Flores G, Nellen H, Magaña F, Calleja J (2002) Acute bilateral emphysematous pyelonephritis successfully managed by medical therapy alone: a case report and review of the literature. BMC Nephrol 3:4PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Sodgi M, Marih L, Nassib M, Himmich H (2006) Bilateral emphysematous pyelonephritis cured by medical therapy alone. Med Mal Infect 36:174–176CrossRefGoogle Scholar
  14. 14.
    Karasavidou L, Nikolaou S, Archontakis S, Papatheodorou G et al (2006) Nonsurgical treatment of bilateral emphysematous pyelonephritis in a diabetic patient. J Nephrol 19:664–667PubMedGoogle Scholar
  15. 15.
    Melero MJ, Sarquis SG, Biancolini C, Baredes N (2007) Acute bilateral emphysematous pyelonephritis: a therapeutic challenge. Medicina (B Aires) 67:282–284Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Mohammad Shafi Kuchay
    • 1
  • Bashir Ahmad Laway
    • 1
  • Manzoor Ahmad Bhat
    • 1
  • Shahnaz Ahmad Mir
    • 1
  1. 1.Department of EndocrinologySher-I-Kashmir Institute of Medical SciencesSrinagarIndia

Personalised recommendations