Emphysematous Pyelitis Complicated by Renal Calculi: A Case Report

Sallami, Sataa; Chelif, M.; Dahmani, Adel; Rhouma, Sami Ben; Dagdagui, Nizar; Hajri, Mohamed; Nouira, Yassine; Horchani, Ali

doi:10.3834/uij.1944-5784.2010.06.10

Cited by 3 publications

(7 citation statements)

References 11 publications

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“…The diagnosis of emphysematous pyelitis is often mistaken clinically as emphysematous pyelonephritis, due to the significant overlap in symptomatology. Both present with flank pain, fever, and chills [ 1 ]. However, it is very important to be able to differentiate between the two, as the management protocols for both differ.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is very important to be able to differentiate between the two, as the management protocols for both differ. Gas in renal parenchyma requires drainage or nephrectomy while pyelitis can be managed with conservative antibiotic therapy and correction of the obstruction, if possible [ 1 , 2 , 5 - 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…USG findings serve as pointers towards the diagnosis, but it is not possible to accurately differentiate air, calculus, and calcifications [ 1 ]. CT is the imaging modality of choice, in diagnosing and following-up gas containing infections of the urinary tract.…”

Section: Discussionmentioning

confidence: 99%

“…CT is the imaging modality of choice, in diagnosing and following-up gas containing infections of the urinary tract. It is possible to give an accurate diagnosis along with an accurate staging on CT [ 1 , 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…If the infection involves the renal parenchyma, it invariably has higher mortality as compared to the isolated involvement of the renal collecting system. These are more common in those with diabetes as a co-morbidity or some aetiology causing long-term obstruction of the urinary pathway [ 1 ]. The organisms generally responsible for gas formation include Escherichia coli, Klebsiella, Proteus, and Pseudomonas [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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CT as a Diagnostic Tool for Emphysematous Pyelitis: A Case Report

Ajmera

Krishnamurthy

Joshi³

et al. 2021

Cureus

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Gas forming infections of the renal collecting system occurs because of organisms like Escherichia coli, Klebsiella, and Proteus. If the gas is restricted to the collecting system, without causing involvement of the cortex, it is called emphysematous pyelitis; whereas, invasion and penetration of the cortex imply a more gruesome diagnosis of emphysematous pyelonephritis. A 59-year-old male patient, previously diagnosed with a large right renal calculus and having multiple co-morbidities presented to the surgery department with right flank pain; Double J (DJ) stenting was done to relieve the pain from colic due to obstructive renal calculi; the patient subsequently discharged without any post-procedural complications. The patient came back a month later with similar complaints and multiple spikes of fever. Blood and urine culture revealed growth of Escherichia coli. The first line radiological investigations, like X-ray and ultrasonography, were suggestive of the presence of air in the pelvis, ureter, bladder; confirmation by CT revealed the presence of air in the collecting system, including the calyx. This air was seen invading focally into the anterior renal cortex. Also, the DJ stent had migrated into the proximal ureter. The patient had developed emphysematous pyelitis predominantly, which had developed an overlapping component of pyelonephritis. The aetiology for air in the renal system was infection by Escherichia coli. CT proved to be diagnostic in differentiating both of them, as the presence of air entering the renal cortex was detected only on CT. Subsequently, prominent initiation of antibiotic therapy and replacement of DJ stent was carried out, following which the patient recovered fully within two weeks.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CT as a Diagnostic Tool for Emphysematous Pyelitis: A Case Report

Ajmera

Krishnamurthy

Joshi³

et al. 2021

Cureus

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Asymptomatic emphysematous pyelitis—a rare clinical entity

et al. 2021

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A 62-year-old asymptomatic woman with diabetes was referred to the urology department from nephrology due to deterioration in renal function with accompanied right-sided hydronephrosis on ultrasound. CT imaging subsequently revealed a right-sided staghorn calculus and a significant volume of gas in the right collecting system from the kidney to the distal ureter, in keeping with emphysematous pyelitis. She was admitted and managed with antibiotics and insertion of right nephrostomy in the first instance, followed by percutaneous nephrolithotomy to definitively manage the stone. The patient remained asymptomatic throughout the process.

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Case Report of an Atypical Abdominal Pain Found to be a Rare Corynebacterium Emphysematous Pyelitis

Singh¹,

Adame²,

Alaie³

2022

Cureus

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Recognizing life-threatening infections is crucial for an emergency physician. In this case report, we describe an atypical presentation of a severe, infiltrating kidney infection, which, if not recognized early, could have led to a detrimental outcome. Emphysematous pyelitis, which is class I of emphysematous pyelonephritis, is a rare entity, and patients may present with a urinary tract infection or pyelonephritis. To add to this, underrecognition of gram-positive organisms, in this case Corynebacterium , can delay treatment and worsen outcomes, as described in this case. Through this case, we wish to create awareness of this disease and to reinforce emergency physicians to keep this entity on their differential diagnosis when evaluating an immunocompromised patient.

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Emphysematous Pyelitis Complicated by Renal Calculi: A Case Report

Abstract: Abbreviations and AcronymsCT = computed tomography EP = emphysematous pyelitis EPN = emphysematous pyelonephritis KUB = kidney, ureter, bladder ABSTRACT

Cited by 3 publications

References 11 publications

CT as a Diagnostic Tool for Emphysematous Pyelitis: A Case Report

CT as a Diagnostic Tool for Emphysematous Pyelitis: A Case Report

Asymptomatic emphysematous pyelitis—a rare clinical entity

Case Report of an Atypical Abdominal Pain Found to be a Rare Corynebacterium Emphysematous Pyelitis

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