Emphysematous Pyelonephritis Involving Native Kidneys and a Transplanted Kidney

Emphysematous pyelonephritis (EPN) is an acute severe necrotizing form of UTI, with air collection in the renal parenchyma, collecting system, and surrounding tissues. Most common causative organisms are Escherichia coli and Klebsiella. Here we present a 71-year-old Caucasian male with multiple medi...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-09, Vol.14 (9)
Main Authors: Chippa, Venu, Chenna, Swetha, Gujarathi, Rahul
Format: Article
Language:English
Subjects:
Abdomen
Abscesses
Antibiotics
Antifungal agents
Blood pressure
Case reports
Classification
Creatinine
Diabetes
E coli
Endoscopy
Hematuria
Hemoglobin
Hospitals
Infections
Infectious Disease
Internal Medicine
Kidney transplants
Medical prognosis
Mortality
Ostomy
Pathogenesis
Patients
Pneumonia
Risk factors
Sepsis
Tracheotomy
Urine
Urology
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Emphysematous pyelonephritis (EPN) is an acute severe necrotizing form of UTI, with air collection in the renal parenchyma, collecting system, and surrounding tissues. Most common causative organisms are Escherichia coli and Klebsiella. Here we present a 71-year-old Caucasian male with multiple medical problems who was transferred to our ER from a long-term acute care hospital (LTACH) for hematuria, UTI, and septic shock. He is a recipient of a deceased donor renal transplant and was receiving IV amphotericin B for recent cryptococcal meningitis. CT abdomen showed bilateral EPN, including the transplanted kidney. He received aggressive fluid resuscitation, vasopressors, and IV antibiotics and got admitted to the ICU. Unfortunately, his clinical course worsened and required ventilatory support, and his family opted for comfort care because of the high mortality rate. The emphasis of this case report is to investigate immunocompromised patients presenting with UTIs for EPN.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.29024