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KMID : 0882420150890050567
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Korean Journal of Medicine
2015 Volume.89 No. 5 p.567 ~ p.570
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A Case of Incidentally Detected Asymptomatic Emphysematous Pyelonephritis
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Lee Hyeon-Jung
Shin Sae-Bom
Go Se-eun
Seo Ju-Hyun
Han Deok-Jae
Cho Hyeong-Jun
Kim Young-Ok
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Abstract
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Emphysematous pyelonephritis (EPN) is a severe gas-forming infection of the renal parenchyma and surrounding tissues. Patients with EPN commonly present with high fever, chills, and flank pain. These symptoms mimic a simple urinary tract infection, such that diagnosis is often delayed. Because of its life-threatening fulminant course, the early detection of EPN and its prompt treatment with intravenous antibiotics with or without percutaneous drainage are critical. Here we describe a case of a 63-year-old Korean female with diabetes mellitus who had no specific symptoms or signs of EPN. A chest computed tomography (CT) scan to assess a right pleural effusion incidentally detected an abnormal gas shadow in the renal parenchyma. An abdominal CT scan performed 5 days later showed increased gas within the kidney parenchyma, but the patient still had no symptoms of EPN. She was treated with intravenous antibiotics alone. A follow-up abdominal CT scan revealed the complete disappearance of the features of EPN.
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KEYWORD
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Emphysematous pyelonephritis, Asymptomatic pyuria, Diabetes mellitus
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