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.
References
Asgari SA (2004) Successful medical treatment of emphysematous pyelonephritis. Urol J 1:282–283
Huang JJ, Tseng CC (2000) Emphysematous pyelonephritis clinicoradiological classification, management, prognosis and pathogenesis. Arch Intern Med 160:797–805
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 62:206–208
Naggapan R, Kletchko S (1992) Bilateral emphysematous pyelonephritis resolving to medical therapy. J Intern Med 232:77–80
George J, Chakravarthy S, John GT, Jacob CK (1995) Bilateral emphysematous pyelonephritis responding to nonsurgical management. Am J Nephrol 15:172–174
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 31:193–197
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 63:252–254
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 16:155–157
Grozel F, Berthezene Y, Guerin C et al (1997) Bilateral emphysematous pyelonephritis resolving to medical therapy: demonstration by US and CT. Eur Radiol 7:844–846
Hildebrand TS, Nibbe L, Frei U, Schindler R (1999) Bilateral emphysematous pyelonephritis caused by Candida infection. Am J Kidney Dis 33:E10
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 36:1267–1270
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 3:4
Sodgi M, Marih L, Nassib M, Himmich H (2006) Bilateral emphysematous pyelonephritis cured by medical therapy alone. Med Mal Infect 36:174–176
Karasavidou L, Nikolaou S, Archontakis S, Papatheodorou G et al (2006) Nonsurgical treatment of bilateral emphysematous pyelonephritis in a diabetic patient. J Nephrol 19:664–667
Melero MJ, Sarquis SG, Biancolini C, Baredes N (2007) Acute bilateral emphysematous pyelonephritis: a therapeutic challenge. Medicina (B Aires) 67:282–284
Conflict of interest
No conflict of interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kuchay, M.S., Laway, B.A., Bhat, M.A. et al. Medical therapy alone can be sufficient for bilateral emphysematous pyelonephritis: report of a new case and review of previous experiences. Int Urol Nephrol 46, 223–227 (2014). https://doi.org/10.1007/s11255-013-0446-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-013-0446-7