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Emphysematous pyelonephritis

Nature Clinical Practice Urology volume 2, pages 108–112 (2005)Cite this article

Abstract

Background A 54-year-old nondiabetic male presented with high fever, vague lower abdominal pain and leakage of urine around his long-standing suprapubic catheter. Examination revealed pyrexia and tenderness in the right renal angle. White cell count was 22.8 × 109/l. Plain abdominal X-ray showed calculi in the right kidney, ureter and bladder. Intravenous pyelogram showed gas confined to the right upper renal pelvis and perinephric space.

Investigations Urine and blood cultures, plain abdominal X-ray, intravenous pyelogram, abdominal ultrasound, MAG3 renogram and histopathology.

Diagnosis Emphysematous pyelonephritis: class 2 or type 1. Escherichia coli was isolated from urine obtained by endoscopic drainage.

Management Endoscopic drainage of pus and simple nephrectomy.

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Figure 1: Intravenous pyleogram showing gas confined to the right upper renal pelvis and perirenal space.
Figure 2: Ultrasound scan of the right kidney, showing gross distension and echogenic debris (arrows) within the collecting system.

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Authors and Affiliations

  1. Worcester–Warwick Basic Surgical Rotation,

    Mohammed Nayeemuddin, Oliver J Wiseman & Alan G Turner

  2. Edith Cavell Hospital, UK

    Mohammed Nayeemuddin, Oliver J Wiseman & Alan G Turner

Authors
  1. Mohammed Nayeemuddin
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  2. Oliver J Wiseman
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  3. Alan G Turner
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Correspondence to Mohammed Nayeemuddin.

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The authors declare no competing financial interests.

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Nayeemuddin, M., Wiseman, O. & Turner, A. Emphysematous pyelonephritis. Nat Rev Urol 2, 108–112 (2005). https://doi.org/10.1038/ncpuro0095

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