Coexistence of emphysematous cystitis and bilateral emphysematous pyelonephritis: a case report and review of the literature

Chávez‐Valencia, Venice; Orizaga-de-la-Cruz, Citlalli; Aguilar-Bixano, Omar; Lagunas‐Rangel, Francisco Alejandro

doi:10.1007/s13730-020-00479-5

Cited by 16 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The treatment protocol for these patients shifts from a conservative approach using antibiotic therapy with renal drainage (percutaneously or stent), which is predicted to lower antibiotic concentrations in the tissue by reducing gas while still improving tissue perfusion, to nephrectomy. For nephrectomy, powerful antibiotic therapy is becoming a more viable alternative [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Emphysematous Pyelonephritis Associated with COVID Pneumonia: A Case Report

2022

View full text Add to dashboard Cite

Patient: Male, 59-year-old Final Diagnosis: Septic shock Symptoms: Septic shock Medication: — Clinical Procedure: CT scan • hemodialysis • mechanical ventilation support • PCN • PCR Specialty: Urology Objective: Unusual clinical course 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). Active therapy – nephrectomy – was ruled out due to the late detection of the gas collection in the kidneys, as well as the general condition caused by respiratory symptoms. With symptomatic, supportive, and antimicrobial therapy, such as percutaneous renal drainage, renal abnormalities improved. Unfortunately, the virus-induced parenchymal inflammation progressed and proved fatal. The inflammatory process in the urothelial cell is most likely where the linkage and potentiation of COVID-19 infection and emphysematous pyelonephritis begins. Local inflammation that obstructs the movement of the generated gas is one of the hypothesized processes of emphysematous pyelonephritis. The renal and urothelial tubular cells contain the angiotensin-converting enzyme II (ACE2) receptor, which is used by the SARS-CoV-2 virus to enter human cells and may be a risk factor for simultaneous and direct viral injury to urinary tract cells. Sepsis was most likely caused by viral pneumonia, based on the resolution of changes in the kidneys. Conclusions: The combination of EPN and COVID-19 is difficult to treat. Despite multidisciplinary treatment, it has been linked to a worse prognosis and fatal outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Bilateral Emphysematous Pyelonephritis Associated with COVID Pneumonia: A Case Report

2022

View full text Add to dashboard Cite

show abstract

“…Usually, it affects diabetic patients, which is not the case with this patient. Moreover, the high urinary sugar level provides a favorable environment for urinary-onset sepsis development, especially EPN, EC, renal, and perirenal abscess, which is already very rare [ 5 ]. Our patient is the first to have grouped this rare combination with SARS-CoV-2 pneumonia complicated by a large abundance of SP.…”

Section: Discussionmentioning

confidence: 99%

Coexistence of Emphysematous Pyelonephritis and Cystitis in a Patient with COVID-19 Complicated with Spontaneous Pneumomediastinum

Boukhannous

Moudane

Chennoufi

et al. 2021

Case Reports in Infectious Diseases

View full text Add to dashboard Cite

We report the first case of a 52-year-old nondiabetic male admitted for management of uremic syndrome associated with emphysematous pyelonephritis (EPN), renal and perinephric abscess, and emphysematous cystitis (EC) on a single functional kidney with a large abundance of spontaneous pneumomediastinum (SP) complicating a SARS-CoV-2 pneumonia. The patient has benefited from several dialysis sessions, intravenous antibiotics, and percutaneous drainage. His clinical course was complicated by acute respiratory distress syndrome, and unfortunately, he died nine days following admission.

show abstract

“…Emphysematous cystitis, a rare disease that results from a bladder infection leading to the accumulation of gas in the bladder wall, occurs most often in 50-70-year-old women with diabetes mellitus. 6,7 Patients with immune dysfunction or urinary diseases also have a higher incidence of EC than the general population. 8 EC is characterized by the general manifestations of bladder inflammation, such as frequent micturition, urgent micturition, dysuria, haematuria, pyuria, waist and abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

“…11 , 12 This gas can be formed from nitrogen, hydrogen, oxygen and carbon dioxide, but it is usually carbon dioxide. 7 Currently, the pathogenesis of EC is not fully understood, but gas production is mainly due to glucose fermentation or protein breakdown. 16 There are also some triggering factors, such as the presence of gas producing substances, high concentrations of glucose and tissue damage, which are beneficial to the occurrence of urinary tract infections and gas production.…”

Section: Discussionmentioning

confidence: 99%

Severe emphysematous cystitis complicated with perforation, bilateral renal cortical atrophy and sepsis: a case report

2020

View full text Add to dashboard Cite

Emphysematous cystitis (EC) is a rare bladder infection characterized by the presence of gas in the wall or cavity of the bladder. Most patients with EC will present with the typical symptoms of cystitis (e.g. frequent micturition, urgent micturition and dysuria), but other signs include distension and pain in the lower abdomen, drum sounds on percussion and a large amount of gas in the bladder. There can also be other complications such as sepsis. However, it is usually characterized by the typical symptoms of infection combined with pneumatinuria, the passage of gas mixed with urine. The early stage of EC is mostly limited to the submucosa and the symptoms of infection can be mild. Some patients may have no obvious clinical symptoms. If the infection becomes severe, it may result in difficulty urinating and kidney dysfunction. Therefore, timely treatment of these rare bladder infections is essential. This current case report describes an 80-year-old female patient with severe EC complicated by significant bilateral ureteral dilatation, bilateral renal cortical atrophy and sepsis. The patient was successfully treated with antibiotics and surgery. This report provides clinical data, test results and treatment experience that might be useful for clinicians that are involved in the treatment of EC.

show abstract

Coexistence of emphysematous cystitis and bilateral emphysematous pyelonephritis: a case report and review of the literature

Cited by 16 publications

References 16 publications

Bilateral Emphysematous Pyelonephritis Associated with COVID Pneumonia: A Case Report

Bilateral Emphysematous Pyelonephritis Associated with COVID Pneumonia: A Case Report

Coexistence of Emphysematous Pyelonephritis and Cystitis in a Patient with COVID-19 Complicated with Spontaneous Pneumomediastinum

Severe emphysematous cystitis complicated with perforation, bilateral renal cortical atrophy and sepsis: a case report

Contact Info

Product

Resources

About