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KMID : 0927720080090030235
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Korean Clinical Diabetes
2008 Volume.9 No. 3 p.235 ~ p.240
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A Case of Emphysematous Pyelonephritis That was Treated Successfully with Medical Therapy Alone and without Surgical Intervention
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Lim Hyo-Seok
Kwon Mi-Kwang
Chon Suk
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Abstract
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Emphysematous pyelonephritis is a rare, but severe, life-threatening necrotizing infection of the upper urinary tract that is characterized by the presence of gas within the renal parenchyma, collecting system or peri-nephric tissue. Therefore it is important to diagnose and treat early, including invasive procedures such as percutaneous nephrostomy or nephrectomy, for better prognosis of patient with emphysematous pyelonephritis. A 72-year-old woman visited to our clinic with symptoms of abdominal pain and febrile sensation. She had been diagnosed with type 2 diabetes mellitus 27 years ago. Mild renal insufficiency was noted based on increased serum creatinine. Abdominal CT revealed gas filled pockets within the right renal parenchyma. According to the radiologic classification of emphysematous pyelonephritis by Huang et al., we could diagnose her with emphysematous pyelonephritis Class 2. But the amount of gas in the renal parenchyma was not too much and the vital sign of the patient was stable. In addition, there were few risk factors predicted unfavorable outcomes except increased serum creatinine level. So, we decided to apply the medical management with intravenous antibiotics to the patient, without any surgical interventions. After 3 weeks from initiatial treatment, she recovered without any complication and gas within renal parenchyma was resolved. (KOREAN CLINICAL DIABETES J 9:235-240, 2008)
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KEYWORD
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Creatinine, Diabetes Mellitus, Type 2, Pyelonephritis
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