Emphysematous pyelonephritis and cystitis associated with bilateral pelviureteric junction obstruction: A case report

Fernandes, Lucio P; Sajwany, Mohammed Jaffer; Derweesh, Asim

doi:10.1016/s0022-3468(98)90203-2

Cited by 14 publications

(14 citation statements)

References 5 publications

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“…Obstructive uropathy, stones and decreased host immunity have been the major risk factors for pediatric EPN. As reported in the literature, EPN may occur in patients with no previous recurrent infectious disease as in the case of severe obstructive congenital uropathy (7, 9). No association has been reported between preoperative urine cultures and outcomes after vesicoureteral reimplantation, suggesting that asymptomatic patients do not require preoperative surveillance (19).…”

Section: Discussionmentioning

confidence: 86%

Emphysematous Pyelonephritis Following Ureterovesical Reimplantation for Congenital Obstructive Megaureter. Pediatric Case Report and Review of the Literature

et al. 2019

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Introduction: Emphysematous pyelonephritis (EPN) is a rare, life-threatening necrotizing infection of the kidney. To date, very few cases of EPN have been described in the pediatric age. The first case of EPN in a toddler occurring after ureterovesical reimplantation for congenital obstructive megaureter is reported with a literature review.Case Report: A 23-month-old male, with a prenatal diagnosis of obstructive megaureter and incomplete duplication of the left urinary tract, was admitted to our Unit where he underwent surgery to treat increased dilatation of the renal pelvis and appearance of an obstructive curve. The latter was revealed at renal scintigraphy, the exam highlighted the radiographic aspect of the cortical renal parenchymal sufferance. At admission preoperative exams were normal, and no recurrent urinary tract infections were documented. Surgical removal of the left stenotic ureteral common tract of the incomplete duplex collecting system was accomplished; ureterovesical reimplantation was performed without ureteral recalibration. No intraoperative complications were recorded. In the immediate postoperative period, urosepsis and the patient's lethargic condition led to life-threatening conditions requiring urgent admission to the intensive care unit. Biochemical analysis showed leukocytosis, anemia, increased C-reactive protein, prolonged prothrombin time, pancytopenia, hyponatremia. Abdominal sonographic evaluation revealed the presence of gas in the left kidney. Unilateral EPN (Class 2) was confirmed by CT- scan. Escherichia coli was cultured from peripheral blood and antimicrobial therapy was started. No additional interventions were required. The child was discharged 14 days postoperatively with normal renal function.Conclusion: EPN is a serious condition that can occur after surgical treatment for urinary tract obstruction. Early detection of air in the kidney should be considered a sign of complicated urinary tract infection. Immediate aggressive resuscitation and antimicrobial therapy are effective and curative with a positive outcome.

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Section: Discussionmentioning

confidence: 86%

Emphysematous Pyelonephritis Following Ureterovesical Reimplantation for Congenital Obstructive Megaureter. Pediatric Case Report and Review of the Literature

et al. 2019

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“…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 …”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous pyelonephritis and cystitis: A case report and literature review

Wang

et al. 2018

J Int Med Res

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This present case report describes a 64-year-old female patient with type 2 diabetes mellitus who also had emphysematous pyelonephritis (EPN) and emphysematous cystitis (EC). Computed tomography revealed well defined emphysematous pyelonephritis and cystitis. Broad-spectrum antibiotic and percutaneous drainage of the right kidney were used as part of a conservative management regimen. The patient achieved clinical recovery and was discharged 12 days after admission. Furthermore, 13 other cases of EPC and EC that were reported between 1962 and 2017 were reviewed and discussed. The overall mortality was 15.4% (two of 13 patients), compared with 25% for EPN alone or 7.4% for EC alone as reported in the literature. The primary pathogen identified in the 13 patients was Escherichia coli (53.8%). All 13 patients were treated with antibiotics.

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“…Het voorkomen van EPN bij kinderen is echter zeer zeldzaam en is voor het eerst door Pode et al beschreven in 1985 bij een 10-jarige vrouwelijke patiënt [3]. Tot op heden zijn er van EPN bij kinderen acht casus verschenen [3][4][5][6][7][8][9].…”

Section: Discussieunclassified

“…Bij kinderen wordt diabetes niet als risicofactor beschreven. De eerder gepubliceerde casus laten zien dat nefro-urolithiase, gestoorde immuniteit en obstructieve uropathie de voornaamste risicofactoren lijken te zijn [3][4][5][6][7][8][9]. In de hier beschreven casus lijkt een PUJ-stenose op basis van overkruisende vaten de oorzakelijke factor.…”

Section: Discussieunclassified

Case report. Emfysemateuze pyelonefritis bij kinderen

Jacobs

Callewaert

2021

Tijdschr Urol

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SamenvattingIn dit case report beschrijven wij het diagnose- en behandeltraject van een 12-jarige patiënt met een emfysemateuze pyelonefritis (EPN) ten gevolge van een pyelo-ureterale junctie stenose. Een EPN bij kinderen is uiterst zeldzaam. De exacte pathogenese van EPN is onbekend, maar het voorkomen lijkt geassocieerd te zijn met obstructie van de urinewegen, stenen of een gestoorde afweer. In tegenstelling tot bij de volwassen populatie met EPN lijkt diabetes mellitus bij kinderen geen risicofactor. Het klinisch beeld van EPN kan variëren van symptomen die passen bij een klassieke pyelonefritis tot een ernstige septische shock. Computertomografisch onderzoek vormt de beste diagnostische modaliteit. Behandeling bestaat uit spoedige resuscitatie van de septische patiënt in combinatie met drainage van de nier in geval van obstructie. De klinische uitkomst bij kinderen is over het algemeen goed.

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Emphysematous pyelonephritis and cystitis associated with bilateral pelviureteric junction obstruction: A case report

Cited by 14 publications

References 5 publications

Emphysematous Pyelonephritis Following Ureterovesical Reimplantation for Congenital Obstructive Megaureter. Pediatric Case Report and Review of the Literature

Emphysematous Pyelonephritis Following Ureterovesical Reimplantation for Congenital Obstructive Megaureter. Pediatric Case Report and Review of the Literature

Emphysematous pyelonephritis and cystitis: A case report and literature review

Case report. Emfysemateuze pyelonefritis bij kinderen

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