Emphysematous Pyelonephritis: Bedside Ultrasound Diagnosis in the Emergency Department

McCafferty, Gillian; Shorette, Amanda; Singh, Sukhdeep; Budhram, Gavin

doi:10.5811/cpcem.2016.12.32714

Cited by 9 publications

(12 citation statements)

References 15 publications

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“…The high acoustic impedance gradient between gas and renal tissues generates artifacts, which can be easily detected on POCUS at the bedside[ 42 , 43 ]. We performed a systematic literature search in PubMed using the key words “POCUS,” “point-of-care ultrasound,” “bedside ultrasound,” “emergency ultrasound,” “ultrasound,” and “emphysematous pyelonephritis.” A total of five other reports focusing on POCUS in EPN were identified[ 3 , 19 , 44 - 46 ] (Table 2 ). A hyperechoic focus with dirty acoustic shadowing is the most common sonographic feature on POCUS for the diagnosis of EPN[ 3 , 19 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…We performed a systematic literature search in PubMed using the key words “POCUS,” “point-of-care ultrasound,” “bedside ultrasound,” “emergency ultrasound,” “ultrasound,” and “emphysematous pyelonephritis.” A total of five other reports focusing on POCUS in EPN were identified[ 3 , 19 , 44 - 46 ] (Table 2 ). A hyperechoic focus with dirty acoustic shadowing is the most common sonographic feature on POCUS for the diagnosis of EPN[ 3 , 19 , 45 ]. However, other imaging features have also been reported, including poor delineation of the kidney, A-lines and B-lines[ 44 - 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…EPN usually presents with a fulminant clinical course and leads to sepsis and septic shock. Misdiagnosis of EPN and delayed management are associated with a mortality rate up to 80%[ 3 ]. Over the past decade, computed tomography (CT)-guided percutaneous catheter drainage (PCD), advanced antibiotic therapy, and intensive care medicine have improved the clinical outcome with a decreased mortality rate of 21%[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Point-of-care ultrasound for the early diagnosis of emphysematous pyelonephritis: A case report and literature review

Xing

Yang

Wen

et al. 2021

WJCC

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BACKGROUND Emphysematous pyelonephritis (EPN) is a rare but fatal necrotic infection of the kidney, which usually leads to septic shock. Therefore, early diagnosis and optimized therapy are of paramount importance. In the past two decades, point-of-care ultrasound (POCUS) has been widely used in clinical practice, especially in emergency and critical care settings, and helps to rapidly identify the source of infection in sepsis. We report a rare case in which a “falls” sign on POCUS played a pivotal role in the early diagnosis of EPN. CASE SUMMARY A 57-year-old man presented with fever and lumbago for 3 d prior to admission. He went to the emergency room, and the initial POCUS detected gas bubbles in the hepatorenal space showing a hyperechoic focus with dirty shadowing and comet-tail artifacts. This imaging feature was like a mini waterfall. His blood and urine culture demonstrated Escherichia coli bacteremia, and EPN associated with septic shock was diagnosed. The patient did not respond to broad-spectrum antibiotic treatment and a perirenal abscess developed. He subsequently underwent computed tomography-guided percutaneous catheter drainage, and fully recovered. We also review the literature on the sonographic features of POCUS in EPN. CONCLUSION This case indicates that a “falls” sign on POCUS facilitates the rapid diagnosis of severe EPN at the bedside.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Point-of-care ultrasound for the early diagnosis of emphysematous pyelonephritis: A case report and literature review

Xing

Yang

Wen

et al. 2021

WJCC

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“…If fluid collections are present, there may be ring-down artifacts from air bubbles trapped within fluid collections. In severe cases in which there is a significant amount of air within the perinephric space, the artifact may completely obscure the kidney 16 (►Fig. 2F).…”

Section: Emphysematous Pyelonephritismentioning

confidence: 99%

Acute Renal Infection in Adult, Part 2: Emphysematous Urinary Tract Infection—What the Radiologist Needs to Know

Hazarika

Venkataramanan

Das

et al. 2020

Journal of Gastrointestinal and Abdominal Radiology

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Renal emphysema, as described by Kelly and MacCallum in 1898, refers to the spontaneous generation of gas within the renal parenchyma and surrounding tissues. Since its initial description, it has become apparent that the spectrum of radiologically visible renal and perirenal gas includes three distinct clinical entities: (1) emphysematous pyelonephritis, a necrotizing infection associated with gas formation in the renal parenchyma, (2) emphysematous pyelitis, in which gas is confined to the renal pelvis and calyces, and (3) gas-forming perinephric abscess. In this article, we will review gas-forming infections of the urinary system in terms of radiological features, clinical manifestations, predisposing factors, and appropriate management guidelines. AbstractKeywords ► emphysematous cystitis ► emphysematous pyelonephritis ► urinary infection

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“…Forward scatter is an ultrasonic path that occurs at a small angle from the underwater object to the camera. This scattering causes low image sharpness and low image contrast [17]. According to the characteristics of light attenuation of underwater colors, the relationship between the absorption coefficient of underwater images with respect to R, G, and B channels is a < (a , a ).…”

Section: Guidelines For Manuscript Preparationmentioning

confidence: 99%

Auxiliary Diagnosis of Hydronephrosis Based on Ultrasound Image Dynamic Enhancement Technique

Liu

Wang

et al. 2020

IEEE Access

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The current research on the detection of hydronephrosis by ultrasound images has some problems such as sensitivity and specificity. In order to improve the diagnosis of hydronephrosis, this study based on ultrasound image enhancement technology, proposed an image processing algorithm that highlights the diagnostic features of hydronephrosis. At the same time, this study combined the transmission of ultrasound in hydronephrosis to analyze and used data collection methods and experimental research methods to improve methods. In addition, this study used the Laplacian operator to enhance the image, enhanced the edge contours and texture parts of the image, and highlighted the partial image of hydronephrosis. Finally, in order to verify the performance of the algorithm proposed in this study, the actual data is collected for verification analysis. The research shows that the proposed algorithm has certain validity and can provide theoretical reference for subsequent related research.

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Emphysematous Pyelonephritis: Bedside Ultrasound Diagnosis in the Emergency Department

Cited by 9 publications

References 15 publications

Point-of-care ultrasound for the early diagnosis of emphysematous pyelonephritis: A case report and literature review

Point-of-care ultrasound for the early diagnosis of emphysematous pyelonephritis: A case report and literature review

Acute Renal Infection in Adult, Part 2: Emphysematous Urinary Tract Infection—What the Radiologist Needs to Know

Auxiliary Diagnosis of Hydronephrosis Based on Ultrasound Image Dynamic Enhancement Technique

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