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Successful medical treatment of emphysematous pyelonephritis in chronic hemodialysis
Author(s) -
Vlachopanos Georgios,
Kassimatis Theodoros,
Zerva Adamantia,
Kokkona Anastasia,
Stavroulaki Eirini,
Zacharogiannis Charilaos,
Agrafiotis Athanasios
Publication year - 2015
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12274
Subject(s) - medicine , hemodialysis , percutaneous , dialysis , urinary system , nephrectomy , antibiotics , diabetes mellitus , kidney disease , abdominal pain , surgery , intensive care medicine , urinary tract obstruction , kidney , microbiology and biotechnology , biology , endocrinology
Emphysematous pyelonephritis ( EPN ) is a life‐threatening renal infection caused by gas‐producing bacteria and fungi. It usually occurs in patients with diabetes and patients with urinary tract obstruction. A combination of systemic antibiotics, percutaneous catheter drainage, or open nephrectomy is typically required to achieve cure. Because of grim prognosis, resorting to interventional methods is frequently inevitable. We report the case of a 77‐year‐old woman with diabetes and end‐stage renal disease on chronic hemodialysis that presented with fever and left flank pain. A bubbly gas pattern inside the left kidney was demonstrated on abdominal computed tomography scan and blood cultures grew Escherichia coli . She was successfully treated solely with systemic antibiotics. This highlights the fact that prompt recognition of imaging findings associated with benign prognosis is essential for a favorable outcome. It allows for an effective management avoiding high‐risk interventions, especially in frail patients with multiple comorbidities. Finally, we review all published cases of EPN in chronic dialysis patients.