Une pyélonéphrite emphysémateuse bilatérale d'évolution favorable après traitement médical seul

Sodqi, M.; Marih, L.; Nassib, M.; Himmich, Hakima

doi:10.1016/j.medmal.2005.12.002

Cited by 8 publications

(2 citation statements)

References 9 publications

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“…Successful nonsurgical management of bilateral EPN has been previously reported by us and others. [ 24 25 26 27 28 29 ] Seven of our 8 patients with bilateral EPN responded to medical treatment alone (5 patients) or a combination of medical treatment and percutaneous catheter drainage (2 patients) while one patient expired.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous pyelonephritis: A 10-year experience with 26 cases

Misgar

Mubarik

Wani

et al. 2016

Indian J Endocr Metab

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Background:Emphysematous pyelonephritis (EPN) is a necrotizing infection which results in gas within the renal parenchyma, collecting system, or perinephric tissue. A majority of cases occur in patients with diabetes mellitus (DM). In EPN, early aggressive medical treatment may avoid nephrectomy.Aims:The aim of this study was to analyze the characteristics of patients with EPN with respect to patient demographics, clinical presentation, diagnostic investigations, microbiological findings, treatment modality and outcome, and the influence of prognostic factors on the outcome.Materials and Methods:We reviewed the hospital records of 26 patients with EPN for clinical, laboratory, radiological, and microbiological findings, treatments given, and outcome. The severity of EPN was graded as per the Huang classification. We applied the reported prognostic factors to our patients to find out whether these factors correlated with failure of conservative treatment.Results:All the study subjects had DM and all but two of them were females. The majority of our patients (61.5%) had extensive EPN (class 3 or 4) and majority (76.9%) had two or more bad prognostic factors. Escherichia coli was the most common causative organism involved in 50% of our cases. Twenty-three (88.5%) of our patients responded to conservative treatment, two required nephrectomy, and one expired on conservative treatment.Conclusions:In this series of patients with EPN, all had DM, nearly all were women, and E. coli was the most frequently isolated pathogen. Nearly a third of our patients had bilateral disease. Despite the presence of two or more bad prognostic factors and extensive EPN (class 3 or 4) in a majority of our patients, conservative treatment afforded a striking success rate of 88.5%. We recommend early aggressive medical treatment and suggest that nephrectomy should be considered only if patients deteriorate or do not improve on conservative treatment.

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Section: Discussionmentioning

confidence: 99%

Emphysematous pyelonephritis: A 10-year experience with 26 cases

Misgar

Mubarik

Wani

et al. 2016

Indian J Endocr Metab

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“…Another such case recently was reported from our institution ( 14 ). Individual cases have been described in which a conservative approach involving good glycemic control, potent antibiotic coverage, and supportive treatment has been found successful ( 15 – 17 ). The two cases described here were managed with prompt imaging, rapid glycemic control, and potent antibiotics.…”

Section: Commentarymentioning

confidence: 99%

Successful Medical Management of Severe Bilateral Emphysematous Pyelonephritis: Case Studies

et al. 2015

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Medical therapy alone can be sufficient for bilateral emphysematous pyelonephritis: report of a new case and review of previous experiences

et al. 2013

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Bilateral emphysematous pyelonephritis (EPN) is an extremely uncommon, life-threatening gas-forming infection of renal parenchyma and its surrounding areas. Surgical treatment, including percutaneous catheter drainage and nephrectomy, has been advocated as the treatment of choice in most of the patients. However, nephrectomy is itself a hazardous intervention in an unstable septic patient. Whenever bilateral disease is present, the need for long-term renal replacement therapy is unavoidable. We present the clinical course of a lady who presented with bilateral EPN and was successfully managed by medical therapy alone. We also reviewed almost all published cases of bilateral EPN that had been managed medically.

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Une pyélonéphrite emphysémateuse bilatérale d'évolution favorable après traitement médical seul

Cited by 8 publications

References 9 publications

Emphysematous pyelonephritis: A 10-year experience with 26 cases

Emphysematous pyelonephritis: A 10-year experience with 26 cases

Successful Medical Management of Severe Bilateral Emphysematous Pyelonephritis: Case Studies

Medical therapy alone can be sufficient for bilateral emphysematous pyelonephritis: report of a new case and review of previous experiences

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