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Emphysematous pyelonephritis: an acute emergency of the upper genitourinary tract

Jamani, Nurjasmine Aida and Hassan, Radhiana and Kamarulzaman, Mohd Nazli (2022) Emphysematous pyelonephritis: an acute emergency of the upper genitourinary tract. Virtual Journal of Emergency Medicine, 29. pp. 1-3. ISSN 2405-4690

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Emphysematous pyelonephritis (EPN) is a severe form of acute infection of the renal parenchyma, collecting system and surrounding tissue, which is life-threatening.1-2 EPN is common among diabetic pa�tients and existing obstructive uropathy. It is predominantly common in females compared to males.2 The clinical presentation is usually non-specific features of upper urinary tract infection such as fever, flank pain, nausea, vomiting, altered sensorium, acute renal failure or even shock. The pathogenesis of EPN is multifactorial.2-3 The most common causative organism cultured from urine and blood of patients includes Escherichia coli and Klebsiella pneumoniae. Anaerobic organism has been cultured such as Bacteroides fragilis, including fungi such as Candida and Aspergillus. Imaging studies such as CT scan is the most definitive modality for diagnosis, demonstrating the presence of gas and the extent of disease. Abdominal x-ray and ultrasonography may be limited in establishing the presence of gas. It is documented that plain abdominal radiography may be able to demonstrate the existence of gas in only 33% of cases. Early aggressive management, including hydration and electrolyte management, strict glycaemic control and antibiotic initiation, are essential in preventing morbidity and mortality.. Emergency ne�phrectomy might be necessary in severe cases that do not respond to antibiotics .

Item Type: Article (Case Report)
Uncontrolled Keywords: Emphysematous pyelonephritis Upper urinary tract infection Gas-forming infection
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Family Medicine (Effective: 1st January 2011)
Kulliyyah of Medicine > Department of Radiology
Kulliyyah of Medicine > Department of Surgery
Date Deposited: 26 Oct 2022 14:59
Last Modified: 26 Oct 2022 15:02
URI: http://irep.iium.edu.my/id/eprint/100833

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