Objective: To report a case of bilateral emphysematous pyelonephritis (EPN) and emphysematous cystitis in a 64-year-old diabetic male with autosomal-dominant polycystic kidney disease (ADPKD). Case Presentation and Intervention: A 64-year-old diabetic male presented with worsening of renal function and fluid overload. Diagnosis was confirmed by computerized tomography (CT scan) and conservative management with broad-spectrum antibiotics was instituted. There was good clinical response and repeated CT scan showed complete resolution. Conclusion: This case shows that conservative management is an acceptable alternative to surgery in EPN occurring with ADPKD. However, it is recommended that patients should be closely monitored, both clinically and radiologically, and percutaneous catheter drainage or surgical intervention carried out whenever deemed necessary.
© 2007 S. Karger AG, Basel
- Emphysematous pyelonephritis
- Emphysematous cystitis
- Autosomal-dominant polycystic kidney disease
- Conservative management
- Angulo JC, Dehaini A, Escribano J, Sanchez-Chapado M: Successful conservative management of emphysematous pyelonephritis, bilateral or in a solitary kidney. Scand J Urol Nephrol 1997;31:193–197.
- Shahatto N, Al Awadhi NZ, Ghazali S: Emphysematous pyelonephritis: surgical implications. Br J Urol 1990;66:572–574.
- Lim CS, Kim WB, Kim YS, et al: Bilateral emphysematous pyelonephritis with perirenal abscess cured by conservative therapy. J Nephrol 2000;13:155–158.
- Tahir H, Thomas G, Sheerin N, Bettington H, Pattison JM, Goldsmith DJ: Successful medical treatment of acute bilateral emphysematous pyelonephritis. Am J Kidney Dis 2000;36:1267–1270.
- Schenkman E, Auriemma P: Bilateral emphysematous pyelonephritis with autosomal dominant polycystic kidney disease. J Urol 1998;159:1633–1634.
- Chou YH, Tiu CM, Chen TW, Chen KK, Chang T: Emphysematous pyelonephritis in a polycystic kidney: demonstration by ultrasound and computed tomography. J Ultrasound Med 1990;9:355–357.
- Shimizu H, Hariu K, Kamiyama Y, Tomomasa H, Iizumi T, Yazaki T, Umeda T: Bilateral emphysematous pyelonephritis with autosomal-dominant polycystic kidney disease successfully treated by conservative method. Urol Int 1999;63:252–254.
- Levinson ED, Weidner FA: Emphysematous pyelonephritis in a polycystic kidney. Urol Radiol 1981;3:39–41.
- Egawa S, Utsunomiya T, Uchida T, Mashimo S, Koshiba K: Emphysematous pyelonephritis, ureteritis, and cystitis in a diabetic patient. Urol Int 1994;52:176–178.
- Huang JJ, Tseng CC: Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis, and pathogenesis. Arch Intern Med 2000;160:797–805.
Dr. Narayanaswamy Arun
Urology Unit, Ward 4, Al-Amiri Hospital
PO Box 4077
13041 Safat (Kuwait)
Tel. +965 6299 701, Fax +965 2424 135, E-Mail firstname.lastname@example.org
Received: November 13, 2005
Revised: May 25, 2006
Number of Print Pages : 3
Number of Figures : 2, Number of Tables : 0, Number of References : 10
Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre)
Vol. 16, No. 2, Year 2007 (Cover Date: February 2007)
Journal Editor: Owunwanne, A. (Kuwait)
ISSN: 1011–7571 (print), 1423–0151 (Online)
For additional information: http://www.karger.com/MPP
Open Access License / Drug Dosage / Disclaimer
Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license
), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.