Saudi Journal of Kidney Diseases and Transplantation

LETTER TO THE EDITOR
Year
: 2021  |  Volume : 32  |  Issue : 1  |  Page : 286--288

Recurrent Emphysematous Pyelonephritis: Report of a Patient with Three episodes


Marramreddy Sravani, Attili Subha, Maria Bethasaida Manuel, Bommu Alekhya, Rapur Ram, Vishnubotla Siva Kumar 
 Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India

Correspondence Address:
Rapur Ram
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh
India




How to cite this article:
Sravani M, Subha A, Manuel MB, Alekhya B, Ram R, Kumar VS. Recurrent Emphysematous Pyelonephritis: Report of a Patient with Three episodes.Saudi J Kidney Dis Transpl 2021;32:286-288


How to cite this URL:
Sravani M, Subha A, Manuel MB, Alekhya B, Ram R, Kumar VS. Recurrent Emphysematous Pyelonephritis: Report of a Patient with Three episodes. Saudi J Kidney Dis Transpl [serial online] 2021 [cited 2022 Jan 20 ];32:286-288
Available from: https://www.sjkdt.org/text.asp?2021/32/1/286/318545


Full Text



To the Editor,

We report a 46-year-lady, type 2 diabetic and hypertensive for the past six years. She presented with three episodes of emphysematous pyelonephritis (EPN). [Table 1] shows the data of the three episodes. [Figure 1],[Figure 2],[Figure 3],[Figure 4],[Figure 5] show computed tomography images of our patient showing evidence of EPN in kidneys and urinary bladder.{Figure 1],{Figure 2},{Figure 3},{Figure 4},{Figure 5}{Table 1}

Our patient dialysis in the second and third episodes. She was treated with the culture-specific antibiotics. The patient returned to the baseline serum creatinine and was withdrawn from dialysis.

There are several reports in the literature about EPN. Huang and Tseng reported a 51-year-female patient.[1] She was a diabetic, had EPN first in the right kidney, for which nephrectomy was done, and later EPN of left kidney for which ureteral stent was performed. In both, the episodes urine culture had shown growth of Escherichia coli. Unfortunately, patient could not be saved in the second episode.[2]

In a report by Wan et al, they described two distinct types of EPN according to the radiological findings. Since the mortality rate for type I EPN (69%) was higher than that for type II (18%), they stressed the fact that the differentiation is important due to the prognostic difference.[3] A study from India by Fatima et al reported an overall survival rate of 86.3%, denoting that the outcome in these patients has improved remarkably compared to perilous results of yesteryears (19/22).[4]

Conflict of interest: None declared.

Informed consent: Informed consent was obtained from the patient included in the study.

References

1Huang JJ, Tseng CC. Emphysematous pyelonephritis: Clinicoradiological classification, management, prognosis, and pathogenesis. Arch Intern Med 2000;160:797-805.
2Huang JJ, Chen KW, Ruaan MK, Tsai HM. Recurrent emphysematous pyelonephritis. A case report. Int Urol Nephrol 1994;26:389-93.
3Wan YL, Lee TU, Bullard MJ, Tsai CC. Acute gas-producing bacterial renal infection: Correlation between imaging findings and clinical outcome. Radiology 1996;198:433-8.
4Fatima R, Jha R, Muthukrishnan J, et al. Emphysematous pyelonephritis: A single center study. Indian J Nephrol 2013;23:119-24.