A case series on emphysematous pyelonephritis of north Kerala: Case series and review of literature

Kevin Araujo, Akshay Krishnan N.K * and Akbar Ali C M

Department of Radio-diagnosis, Dr. Moopen's Medical College, Wayanad, Kerala, India.
 
Case Report
International Journal of Frontiers in Medicine and Surgery Research, 2023, 03(02), 051–060.
Article DOI: 10.53294/ijfmsr.2023.3.2.0079
Publication history: 
Received on 01 July 2023; revised on 13 August 2023; accepted on 15 August 2023
 
Abstract: 
Background-Emphysematous pyelonephritis (EPN) is an acute necrotizing infection of the renal parenchyma and surrounding tissues resulting in gas formation in the renal parenchyma, collecting system and perinephric tissue. It's a life- threatening infection if not detected and treated promptly. High mortality rate in EPN is due to its septic complications. The most common predisposing factors to this entity are uncontrolled diabetes mellitus, immune incompetence, and urinary tract obstruction. While clinically difficult to detect, radiological confirmation can help clinch the diagnosis. A plain x-ray can raise suspicion of abnormal gas shadow in the renal fossa, based on which ultrasonography or computed tomography can be performed. The latter confirms the presence of intrarenal gas and supports the diagnosis of EPN. As the most common gas-forming organisms are E.coli and Klebsiella, treatment can be initiated after a radiological suspicion to prevent sepsis and morbidity. Here, we present 5 cases of EPN diagnosed by various radiological modalities and brief review of existing literature
 
Keywords: 
Renal abscess; Necrotising infection; Klebsiella
 
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