Emphysematous pyelonephritis successfully treated by early intervention using a renoureteral catheter

Abstract A 49-year-old woman with poorly controlled type 2 diabetes mellitus was admitted to hospital complaining of fever, vomiting, and lower abdominal pain. Laboratory investigation revealed leukocytopenia, high blood sugar, and pyuria. Pyelonephritis was then diagnosed. Escherichia coli was isol...

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Bibliographic Details
Published in:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2009, Vol.15 (3), p.195-198
Main Authors: Teruya, Hiromitsu, Higa, Futoshi, Tateyama, Masao, Fujita, Jiro, Mouri, Takako, Yamamoto, Toshikazu, Kagawa, Haruo
Format: Article
Language:English
Subjects:
Acute Disease
Anti-Bacterial Agents - administration & dosage
Case Report
Diabetes mellitus
Diabetes Mellitus, Type 2 - complications
Emphysema - diagnosis
Emphysema - drug therapy
Emphysema - microbiology
Emphysematous pyelonephritis
Escherichia coli
Escherichia coli - isolation & purification
Escherichia coli Infections - complications
Escherichia coli Infections - diagnosis
Escherichia coli Infections - drug therapy
Female
Hematology, Oncology and Palliative Medicine
Humans
Infectious Diseases
Medical Microbiology
Medicine
Medicine & Public Health
Middle Aged
Pyelonephritis - diagnosis
Pyelonephritis - drug therapy
Pyelonephritis - microbiology
Renoureteral catheter
Tomography, X-Ray Computed
Urinary Catheterization
Virology
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Summary:Abstract A 49-year-old woman with poorly controlled type 2 diabetes mellitus was admitted to hospital complaining of fever, vomiting, and lower abdominal pain. Laboratory investigation revealed leukocytopenia, high blood sugar, and pyuria. Pyelonephritis was then diagnosed. Escherichia coli was isolated from blood and urinary cultures. In spite of antimicrobial therapy, the patient's condition deteriorated. A computed tomography scan of the abdomen on the second day of hospitalization revealed the presence of air in the collecting system of the left kidney. Emphysematous pyelonephritis was diagnosed, and a renoureteral catheter was promptly inserted via the left ureter into the affected pelvis of the left kidney. Imipenem, cefotiam, and levofloxacin were administered during the clinical course. This early intervention and the appropriate antimicrobial therapy were effective in resolving the infection. Urinary tract infections should be carefully managed in patients with poorly controlled diabetes mellitus.
ISSN:1341-321X
1437-7780
DOI:10.1007/s10156-009-0679-7