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PubMed1985

Necrotizing emphysematous pyelonephritis: a case report.

Emphysematous pyelonephritis (EP) is comparatively rare in urological practice. From 1898 to the present time only 45 cases have been described. In this report we describe the case of a 43-year old diabetic man, with right EP without obstruction of the urinary tract and with a urinary infection of E. Coli. This appears to be rather rare as it is more frequently associated with obstruction of the urinary tract. Surgical exploration enabled us to discover a fistula between the kidney and the wall of the vena cava which would have caused fatal complications if it had not been discovered. The micro-organisms more frequently involved were E. Coli, Proteus, Aerobacter and various anaerobes. Mortality has been reported as 75% in patients receiving medical therapy only and 23% in those undergoing surgery. The authors therefore believe that surgical exploration even with no urinary tract obstruction makes it possible to detect complicating pathologies which may remain undiscovered by medical examination and the urinary excretory tract and renal sheath drained. This provides a better opportunity of estimating possible reversibility of the renal lesion.

Adult↗
PubMed1974

Emphysematous pyelonephritis.

A case of emphysematous pyelonephritis with perirenal gas is presented. This patient underwent vigorous medical treatment followed by nephrectomy and survived. This condition has a high mortality and should be distinguished from less severe infections where gas is confined to the collecting system. This case and others previously reported suggest that treatment should initially be medical, followed by early surgical intervention consisting of either drainage or nephrectomy depending upon the degree of renal involvement.

Adult↗
PubMed1983

[Xanthogranulomatous pyelonephritis in children. Report of 4 cases].

Xanthogranulomatous pyelonephritis (X.G.P.) is a rare unilateral manifestation of chronic interstitial nephritis. 4 new cases of X.G.P. in children are reported. The authors review 60 cases of the literature since 1963. The X.G.P. has no predominant sex distribution. The age extended especially between 1 to 5 years. The diffuse type is more common in boys, and the localized type in girls. The clinical signs : fever, abdominal pain, weight loss, urinary infection, abdominal mass. Proteus Mirabilis is the main organism in the diffuse form and Escherichia Coli in the focal form. Actually, the disease is often diagnosed before surgery. The treatment is always nephrectomy and the prognosis is very good (benign). The final diagnosis of X.G.P. can only be made by histological examination. Etiopathogenesis remains obscure : urinary tract infection and obstruction, arterial and veinous lesions, local immunity deficiency.

Adolescent↗