Concurrent Bilateral Emphysematous Pyelonephritis and Emphysematous Cystitis: A Case Report of Glomerulonephritis Severe Complication

Abstract

Emphysematous pyelonephritis (EPN) and emphysematous cystitis (EC) are severe, necrotizing emphysematous urinary tract infections (EUTI) characterized by the presence of gas in the lumen and wall of the urinary tract and renal parenchyma. EUTIs are quite uncommon, but combination of bilateral EPN and EC is extremely rare. We report a case of 57-year-old diabetic female diagnosed with septic shock due to concurrent bilateral EPN and EC. Patient was successfully treated with a drainage of pelvicalyceal systems and the bladder combined with a conservative approach. This unique case presents a possible association between glomerulonephritis and EUTI.

Emphysematous Pyelonephritis, Emphysematous Cystitis, and Emphysematous Ureteritis: A Case Report

“…DM is a major risk factor for these infections, of which our patient has a long-standing history [ 14 ]. Other noteworthy risk factors include older age group, female gender, neurogenic bladder, bladder outlet obstruction, excessive alcohol consumption, indwelling foley catheters, recurrent urinary tract infections, and immunosuppression [ 4 ]. Females are at increased risk of developing UTIs, and this is thought to be the reason for gender predilection in the case of EUTIs as well [ 5 ].…”

“…The concurrence of EUTIs in cases of EC is 15.4%. EUTIs are life-threatening illnesses with a mortality rate of up to 50% [4][5][6]. Diabetes mellitus (DM) is the single most common risk factor with 95% of patients diagnosed with EUTIs having uncontrolled DM [5].…”