Emphysematous pyelonephritis and cystitis: A case report and literature review

J Int Med Res. 2018 Jul;46(7):2954-2960. doi: 10.1177/0300060518770341. Epub 2018 Jun 19.

Abstract

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.

Keywords: Emphysematous pyelonephritis; conservative management; emphysematous cystitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • China
  • Cystitis / diagnostic imaging*
  • Cystitis / microbiology
  • Cystitis / therapy
  • Diabetes Mellitus, Type 2 / complications
  • Drainage
  • Emphysema / diagnostic imaging*
  • Emphysema / microbiology
  • Emphysema / therapy
  • Escherichia coli / isolation & purification*
  • Escherichia coli Infections / diagnostic imaging
  • Escherichia coli Infections / microbiology*
  • Escherichia coli Infections / therapy
  • Female
  • Humans
  • Middle Aged
  • Pyelonephritis / diagnostic imaging*
  • Pyelonephritis / microbiology
  • Pyelonephritis / therapy

Substances

  • Anti-Bacterial Agents