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Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature

Received: 15 July 2023    Accepted: 8 September 2023    Published: 27 September 2023
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Abstract

Introduction: Emphysematous pyelonephritis is a rare and serious medical-surgical condition. Emergency nephrectomy is the standard treatment for forms that respond poorly to medical therapy, in conjunction with drainage of the upper excretory tract. Case report: This is a case of emphysematous pyelonephritis in a 54-year-old female patient who had presented with acute pyelonephritis, left renal colic and hyperactivity syndrome. A non-injected abdominopelvic CT scan revealed a globular, dedifferentiated left kidney with a diffuse aortic component. The right kidney was unremarkable. In intensive care, despite placement of a double JJ tube and antibiotic therapy with amikacin and cefotaxime, the patient's hemodynamic and neurological status continued to deteriorate, necessitating intubation. After 24 hours of well-managed treatment with no improvement, nephrectomy was performed in the setting of emphysematous destruction of the left kidney and persistent latent shock. Based on this observation and a review of the literature, we describe the clinical and radiological features, as well as the various diagnostic and therapeutic means of this condition. Conclusion: the diagnosis of emphysematous pyelonephritis should be suspected in the following cases: the presence of severe acute pyelonephritis, with no improvement in clinical condition despite well-conducted medical treatment or percutaneous drainage, or associated with signs of severity, particularly in diabetics, radical treatment is envisaged after failure of drug therapy.

Published in International Journal of Clinical Urology (Volume 7, Issue 2)
DOI 10.11648/j.ijcu.20230702.16
Page(s) 53-56
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Nephrectomy, Emphysematus Pyelonephritis, Diabtic, Hospital National Ignace Deen, Emergengy

References
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[2] E. Kaiser, R. Fournier Emphysematous pyelonephritis: diagnosis and treatment Annales d'urologie 39 (2005) 49-60.
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[4] Sarf I, Meziane A, Dahami Z, Dakir M, Jaoual A, Bennani S, et al. Emphysematous pyelonephritis: review of the literature concerning a case report. Ann Urol 2003; 37: 54-6.
[5] WanYL, Lo SK, Bullard MJ, Chang PL, Lee TY. Predictors of outcome in emphysematous pyelonephritis. J Urol 1998; 159: 369-73.
[6] Grimaldi A. Diabète de type 2: l'épidémie annoncée est en cours. Rev Prat. 2003; 53 (10): 1067-8.
[7] R. Kapoor, K. Muruganandham, A. K. Gulia, M. Singla, S. Agrawal, A. Mandhani, A. Srivastava, Predictive factors for mortality and need for nephrectomy in patients with emphysematous pyelonephritis, BJU Int. 105 (7) (2010) 986-989.
[8] Miane D, Beatrix O, Bregion M, Sabbah P, Altobelli A, Boyer C. Pyélonéphrite emphysémateuse. Complication rare du diabète sucré. Med Armees. 1996; 24: 583-6.
[9] K. Aswathaman, G. Gopalakrishnan, L. Gnanaraj, N. K. Chacko, N. S. Kekre, A. Devasia, Emphysematous pyelonephritis: outcome of conservative management, Urology 71 (6) (2008) 1007–1009.
[10] Emphysematous cystitis: illustrative case report and review of the literature. Grupper M, Kravtsov A, Potasman I. Medicine (Baltimore) 2007; 86: 47–53.
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[13] Pyélonéphrite emphysémateuse fulminante à Candida glabrata dans une allogreffe de rein. Cases-Corona C, Shabaka A, Gonzalez-Lopez A, Martin-Segarra O, Moreno de la Higuera MA, Lucena R, Fernandez-Juarez G. Nephron. 2020; 144: 304-309.
[14] Moez Rahoui *, Yassine Ouanes, Kays Chaker, Mokhtar Bibi Predictive factors for failure of conservative management in patients with emphysematous pyelonephritis Annals of Medicine and Surgery 78 (2022) 103930.
[15] M. E. Falagas, V. G. Alexiou, K. P. Giannopoulou, Siempos II, Risk factors for mortality in patients with emphysematous pyelonephritis: a meta-analysis, J. Urol. 178 (2007) 880–885.
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Cite This Article
  • APA Style

    Bah Mamadou Bissiriou, Barry Mamadou Madiou, Barry Mamadou Dian, Diallo Thierno Oumar, Sow Thierno Amadou Oury, et al. (2023). Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature. International Journal of Clinical Urology, 7(2), 53-56. https://doi.org/10.11648/j.ijcu.20230702.16

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    ACS Style

    Bah Mamadou Bissiriou; Barry Mamadou Madiou; Barry Mamadou Dian; Diallo Thierno Oumar; Sow Thierno Amadou Oury, et al. Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature. Int. J. Clin. Urol. 2023, 7(2), 53-56. doi: 10.11648/j.ijcu.20230702.16

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    AMA Style

    Bah Mamadou Bissiriou, Barry Mamadou Madiou, Barry Mamadou Dian, Diallo Thierno Oumar, Sow Thierno Amadou Oury, et al. Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature. Int J Clin Urol. 2023;7(2):53-56. doi: 10.11648/j.ijcu.20230702.16

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  • @article{10.11648/j.ijcu.20230702.16,
      author = {Bah Mamadou Bissiriou and Barry Mamadou Madiou and Barry Mamadou Dian and Diallo Thierno Oumar and Sow Thierno Amadou Oury and Frederic Arroua and Marc Fourmarier and Christophe Eghazarian},
      title = {Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature},
      journal = {International Journal of Clinical Urology},
      volume = {7},
      number = {2},
      pages = {53-56},
      doi = {10.11648/j.ijcu.20230702.16},
      url = {https://doi.org/10.11648/j.ijcu.20230702.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20230702.16},
      abstract = {Introduction: Emphysematous pyelonephritis is a rare and serious medical-surgical condition. Emergency nephrectomy is the standard treatment for forms that respond poorly to medical therapy, in conjunction with drainage of the upper excretory tract. Case report: This is a case of emphysematous pyelonephritis in a 54-year-old female patient who had presented with acute pyelonephritis, left renal colic and hyperactivity syndrome. A non-injected abdominopelvic CT scan revealed a globular, dedifferentiated left kidney with a diffuse aortic component. The right kidney was unremarkable. In intensive care, despite placement of a double JJ tube and antibiotic therapy with amikacin and cefotaxime, the patient's hemodynamic and neurological status continued to deteriorate, necessitating intubation. After 24 hours of well-managed treatment with no improvement, nephrectomy was performed in the setting of emphysematous destruction of the left kidney and persistent latent shock. Based on this observation and a review of the literature, we describe the clinical and radiological features, as well as the various diagnostic and therapeutic means of this condition. Conclusion: the diagnosis of emphysematous pyelonephritis should be suspected in the following cases: the presence of severe acute pyelonephritis, with no improvement in clinical condition despite well-conducted medical treatment or percutaneous drainage, or associated with signs of severity, particularly in diabetics, radical treatment is envisaged after failure of drug therapy.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature
    AU  - Bah Mamadou Bissiriou
    AU  - Barry Mamadou Madiou
    AU  - Barry Mamadou Dian
    AU  - Diallo Thierno Oumar
    AU  - Sow Thierno Amadou Oury
    AU  - Frederic Arroua
    AU  - Marc Fourmarier
    AU  - Christophe Eghazarian
    Y1  - 2023/09/27
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    DO  - 10.11648/j.ijcu.20230702.16
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 53
    EP  - 56
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20230702.16
    AB  - Introduction: Emphysematous pyelonephritis is a rare and serious medical-surgical condition. Emergency nephrectomy is the standard treatment for forms that respond poorly to medical therapy, in conjunction with drainage of the upper excretory tract. Case report: This is a case of emphysematous pyelonephritis in a 54-year-old female patient who had presented with acute pyelonephritis, left renal colic and hyperactivity syndrome. A non-injected abdominopelvic CT scan revealed a globular, dedifferentiated left kidney with a diffuse aortic component. The right kidney was unremarkable. In intensive care, despite placement of a double JJ tube and antibiotic therapy with amikacin and cefotaxime, the patient's hemodynamic and neurological status continued to deteriorate, necessitating intubation. After 24 hours of well-managed treatment with no improvement, nephrectomy was performed in the setting of emphysematous destruction of the left kidney and persistent latent shock. Based on this observation and a review of the literature, we describe the clinical and radiological features, as well as the various diagnostic and therapeutic means of this condition. Conclusion: the diagnosis of emphysematous pyelonephritis should be suspected in the following cases: the presence of severe acute pyelonephritis, with no improvement in clinical condition despite well-conducted medical treatment or percutaneous drainage, or associated with signs of severity, particularly in diabetics, radical treatment is envisaged after failure of drug therapy.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Urology Department, Ignace Deen Hospital, Conakry, Guinea; Urology Department, Centre Hospitol Aix-Pertuis, Aix, France

  • Urology Department, Ignace Deen Hospital, Conakry, Guinea

  • Urology Department, Ignace Deen Hospital, Conakry, Guinea

  • Urology Department, Ignace Deen Hospital, Conakry, Guinea

  • Urology Department, Ignace Deen Hospital, Conakry, Guinea

  • Urology Department, Centre Hospitol Aix-Pertuis, Aix, France

  • Urology Department, Centre Hospitol Aix-Pertuis, Aix, France

  • Urology Department, Centre Hospitol Aix-Pertuis, Aix, France

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