Concurrent emphysematous pyelonephritis, cystitis, and iliopsoas abscess from discitis in a diabetic woman

Abstract

Concurrent emphysematous pyelonephritis, cystitis, and iliopsoas abscess from discitis in a diabetic woman A 60-year-old diabetic Taiwanese woman presented to the emergency department with lower back pain of 2-week duration. Physical examination revealed local tenderness over the lower back region; bilateral knocking pain was noted at the costovertebral angle. Laboratory investigations revealed a white blood cell (WBC) count of 4.5 Â 10 9 /l (normal value 4-11 Â 10 9 /l) with band forms of 2% and segmented neutrophils of 96%, creatinine of 2.3 mg/dl (normal value 0.7-1.4 mg/dl), C-reactive protein (CRP) of 25.32 mg/dl (normal value <0.3 mg/dl), blood glucose of 567 mg/ dl (normal value 70-110 mg/dl), and the presence of ketone bodies. Spot urine revealed pyuria. A spinal X-ray showed radiolucency along the bilateral psoas muscles, with extension International Journal of Infectious Diseases 51 (2016) 105-106 Figure 1. Anteroposterior view of the lumbar spine showing compression of the first lumbar spine, radiolucency along the bilateral psoas muscles (white arrows in A) suggestive of bilateral emphysematous iliopsoas abscess with extension to the left hip joint (black arrow in A), and air within the bladder (hollow black arrow in A) suggestive of emphysematous cystitis. The axial and coronal contrast-enhanced abdominal computed tomography (CT) scan views revealed compression of the first lumbar spine with air bubbles within the spine and spinal canal (pneumorrhachis), bilateral emphysematous iliopsoas abscess (white arrows in B and C) with extension to the left hip joint (black arrow in D), left emphysematous pyelonephritis (hollow white arrows in B and C), and emphysematous cystitis (hollow black arrow in D).

Emphysematous pyelonephritis and cystitis: A case report and literature review

“…After filtering for unrelated results and duplicates, the data from 13 patients in 12 publications (one retracted) from 1962 to 2017 were collected and analysed (Table 1). 2,3,6–14 …”

“…After filtering for unrelated results and duplicates, the data from 13 patients in 12 publications (one retracted) from 1962 to 2017 were collected and analysed (Table 1). 2,3,[6][7][8][9][10][11][12][13][14] As shown in Table 2, the mean age of patients that were affected by EPN complicated by coexistent EC was 55 years. The overall mortality rate was 15.4% (two of 13 patients) compared with 25% for EPN alone 15 or 7.4% for EC alone.…”

“…Clinical and demographic data from case reports (n ¼ 13) of emphysematous pyelonephritis (EPN) complicated by coexistent emphysematous cystitis (EC) published from 1962 to 2017 2,3,[6][7][8][9][10][11][12][13][14]. Author…”

“…Summary characteristics for the case reports (n ¼ 13) of emphysematous pyelonephritis complicated by coexistent emphysematous cystitis published from 1962 to 2017 2,3,[6][7][8][9][10][11][12][13][14]. Data presented as mean AE SD or n of patients (%).One article was retracted by the authors, but the rare case was still worth analysing (Ahsaini M, Kassogue A, Tazi MF, et al Emphysematous cystitis and emphysematous pyelitis: a clinically misleading association.…”

Pielonefritis enfisematosa: Revisión de la fisiopatología y tratamiento

“…(10) Existen casos incluso de presentación atípica como cuadros que mimetizan obstrucción intestinal, cuadros con extensión de gas a páncreas, discos vertebrales, casos reportados de afección de injertos renales post trasplante. (10)(11)(12)(13)(14)(15) Revista…”