Emphysematous pyelonephritis related to specific gas-forming Escherichia coli without diabetes mellitus

1999 ◽  
Vol 25 (6) ◽  
pp. 628-630 ◽  
Author(s):  
E. Hazouard ◽  
D. Barat ◽  
P. Lanotte ◽  
L. Brunereau ◽  
T. Lefrancq ◽  
...  
2014 ◽  
Vol 8 (3-4) ◽  
pp. 256 ◽  
Author(s):  
Antonio Tienza ◽  
Mateo Hevia ◽  
Imanol Merino ◽  
Jose Maria Velis ◽  
Ruben Algarra ◽  
...  

Emphysematous pyelonephritis is an acute necrotizing infection with gas in the kidney and perinephric space that carries a bad prognosis. Apart from its predisposing clinical entities, diabetes mellitus and immune-incompetence are quite common in patients with this infection. We report a case of a 53-year-old kidney transplant recipient diabetic male, suffering from recurrent fever, abdominal pain and nausea episodes. Immediate broad-spectrum antibiotics were administered and percutaneous drainage was performed after the diagnosis. The bacteria involved were Stahpylococcus epidermidis and Escherichia coli. After 4 weeks of antibiotic treatment and abscesses drainage, the case was resolved. Consecutives urine cultures and ultrasonographies confirm the complete resolution of the disease. We discuss the predisposing factors, clinical presentation and management.


2021 ◽  
pp. 201010582199280
Author(s):  
Hany Haqimi Wan Hanafi ◽  
Nazri Mustaffa ◽  
Yeong Yeh Lee ◽  
Siti Nurbaya Mohd Nawi

The association between emphysematous pyelonephritis (EPN) and diabetes mellitus is well known. EPN as the cause of sepsis in hepatocellular carcinoma (HCC) is rare and unreported. We report a case of EPN in a non-diabetic HCC patient, in which the clinical features of decompensated chronic liver disease masked the more sinister urological emergency to a certain degree. A computed tomography scan of the abdomen revealed a mixture of gas and fluid in the left retrorenal space, in keeping with left EPN. Nevertheless, the course of clinical deterioration was rather rapid that any surgical intervention was not feasible.


2021 ◽  
Vol 14 (7) ◽  
pp. e243891
Author(s):  
Abdul Wahab ◽  
Muhammad Hashim Hayat ◽  
Amman Yousaf ◽  
Raseen Tariq

2018 ◽  
pp. bcr-2018-225931 ◽  
Author(s):  
Stuart Deoraj ◽  
Fady Zakharious ◽  
Ashraf Nasim ◽  
Constantinos Missouris

Emphysematous pyelonephritis (EPN) is a rare, necrotising infection of the renal parenchyma, predominantly associated with Escherichia coli infection and unless promptly recognised and dealt with, it carries a poor prognosis. The current treatment is one of antimicrobial therapies together with nephrectomy in a majority of patients. We report an elderly man with multiple comorbidities with a diagnosis of EPN whose condition improved with antimicrobial and supportive therapy, and no surgical intervention was required.


2019 ◽  
Vol 10 (1) ◽  
pp. 50-55
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin

Background: Diabetic foot is one of the most feared complications of diabetes and is the leading cause of hospitalization in diabetic patients. Limb-threatening diabetic infections are usually polymicrobial involving multiple aerobic and anaerobic organisms. Methodology: The present study was a cross sectional study, conducted in the department of surgery and microbiology at BIRDEM General Hospital, Dhaka, over a period of 9 months during January 2017- September' 2017. The study included a total of 77 adult patients of clinically diagnosed diabetic foot patients presenting to outpatient department and emergency ward. The standard case definition of diabetic foot is 'any pathology occurring in the foot of a patient suffering from diabetes mellitus or as a result of long term complication of diabetes mellitus'. Results: Majority 17(22.1%) patients had Klebsiella pneumonia, 14(18.2%) had Pseudomonas aeruginosa, 11(14.3%) had Staphylococcus aureus, 10(13.0%) had Escherichia coli, 6(7.8%) had Coagulase-negative staphylococci and 8(10.4%) had Providencia spp. In Escherichia coli 100% sensitivity to imipenem, 70% to amoxicillin-clavulanic acid, amikacin, piperacillin-tazobactam. In Coagulasenegative Staphylococci 83.3% sensitivity to tetracycline, 66.7% to ceftriaxone. In Proteus mirabilis 100% sensitivity to tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam. In Enterococcus spp.75.0% sensitivity to tetracycline. In Citrobacter spp. 100% sensitivity to imipenem. Conclusion: Common organism found in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Coagulase-negative staphylococci and Providencia spp. In tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam was 100% sensitive in Proteus mirabilis and only imipenem found in Escherichia coli and Citrobacter spp. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 50-55


2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Andreas Schicho ◽  
Christian Stroszczynski ◽  
Philipp Wiggermann

Although high mortality rates have been reported for emphysematous pyelonephritis (EP), information on emphysematous cystitis (EC), which is less common, is sparse. Here, we report one new case of severe EC and 136 cases of EC that occurred between 2007 and 2016, and review information about the characteristics, diagnosis, treatment and mortality of these patients, and the pathogens found in these patients. The mean age of the 136 patients was 67.9±14.2 years. Concurrent emphysematous infections of other organs were found in 21 patients (15.4%), with emphysematous pyelonephritis being the most common of these infections. The primary pathogen identified was <em>Escherichia coli</em> (54.4%). Patients were mainly treated by conservative management that included antibiotics (n=105; 77.2%). Ten of the 136 patients with EC died, yielding a mortality rate of 7.4%. Despite the relatively low mortality rate of EC compared with that of EP, a high degree of suspicion must be maintained to facilitate successful and conservative management.


1969 ◽  
Vol 3 (4) ◽  
pp. 178-184
Author(s):  
Adrelírio J. R. Gonçalves ◽  
Leopoldo F. Saldanha ◽  
Sílvio Henrique ◽  
Marcos Hoette ◽  
Vitorino M. dos Santos ◽  
...  

São apresentados 31 casos de bacteremia por gram-negativos, assunto que vem merecendo muita atenção dos pesquisadores nos últimos anos. Os organismos etiológicos mais importantes que apareceram em igualdade de freqüência foram Escherichia coli e Klebsiella-Aerobacter, sendo responsáveis por 58% do total das infecções, seguidos por Pseudomonas. A porta de entrada mais freqüente foi o trato urinário em 61,3% dos casos. A infecção foi mais comum no sexo masculino e a faixa etária de 50 a 60 anos predominou. O uso prévio de antibióticos foi um fator predisponente muito importante, seguido pelo uso de esteróides e citostáticos. As principais doenças predisponentes foram diabetes mellitus e neoplasias malignas. Os principais fatores precipitantes foram a manipulação do aparelho urinário, com infecção prévia ou desencadeada, cirurgia do aparelho digestivo, uronatia obstrutiva e obstrução biliar. As principais manifestações clínicas foram a presença de febre, calafrios e hipotensão arterial. A complicação mais freqüente foi o choque bacteriano que incidiu em 58% dos casos, aproximadamente três vêzes aquela relatada na literatura. As outras foram a insuficiência renal aguda, superinfecção e infecção pulmonar metastática. Considerações terapêuticas gerais e esquemas de antibióticos são propostos para estes casos. A mortalidade da bacteremia simples foi de 30,7% e quando associada ao choque elevou-se para 72,2% . As infecções por Pseudomonas foram 100% fatais.


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