Pielite enfisematosa unilateral: relato de caso / Unilateral emphysematous pyelitis: case report

The present report describes the case of a 22-year-old female patient admitted to the emergency room with acute low back pain, dysuria, vomiting and fever (38.5ºC). Urinalysis and computed tomography findings revealed urinary tract infection associated with presence of gas in the collecting system, characterizing unilateral emphysematous pyelitis caused by Gram-negative bacteria. The present case report emphasizes the occurrence of this disease as a urinary tract infection complication.

Relata-se um caso de paciente de 22 anos de idade, gênero feminino, que foi admitida no pronto-socorro com lombalgia aguda, disúria, vômitos e febre (38,5ºC). Os achados de exames de urina e tomografia computadorizada demonstraram infecção no trato urinário associada a gás no sistema coletor, configurando pielite enfisematosa unilateral por Gram-negativo. O presente relato enfatiza a ocorrência deste agravo como complicação de infecção no trato urinário.

A Case of Bilateral Emphysematous Pyelitis in a Diabetic End-stage Renal Disease Patient Undergoing Peritoneal Dialysis Therapy / 대한신장학회지

Emphysematous pyelitis is uniquely characterized by gas-forming infection restricted to the renal collecting system. This disease entity is uncommon, and shows preferred occurrence in patients with diabetes mellitus or urinary tract obstruction. We report a case of bilateral emphysematous pyelitis in a diabetic end-stage renal disease patient undergoing peritoneal dialysis therapy. The patient was treated by medical treatment only and then recovered from infection, and she has maintained peritoneal dialysis until today. The authors report this case as a successful medical treatment for emphysematous pyelitis accompanying multiple risk factors, such as diabetes mellitus, amorphous medullary kidney stones, and even underlying maintaining peritoneal dialysis.

A Case of Emphysematous Pyelitis in a Renal Transplant Recipient / 대한이식학회지

Emphysematous pyelitis (EP) is a rare complication of urinary tract infection, which has been defined as isolated gas production inside the excretory system. Contrary to emphysematous pyelonephritis, which is more severe, necrotizing infection of the renal parenchyma, EP is a benign entity. To our knowledge, it has not been reported in the Korean literature, particularly in renal transplant recipients. Herein we report a case of EP in a living renal transplant recipient. A 32-year-old man received a living related renal transplant 4 years earlier for end-stage renal disease secondary to chronic glomerulonephritis. The patient presented with a sudden onset of chills, nausea, vomiting and pain on graft area. He was diagnosed as EP by computerized tomography. Immunosuppressive agents were modified and he was successfully treated with parenteral antibiotics with complete disappearance of air in the renal pelvis.

Air in the kidney: between emphysematous pyelitis and pyelonephritis

Presence of air in the kidney can be problematic as the location of the air in different parts of the kidney greatly affects the subsequent management and outcome of the patient. We present here a case of a patient who had emphysematous pyelitis, in which CT scan was able to display presence of air only in the collecting system, thus differentiating this condition from the more fulminant emphysematous pyelonephritis. This leads to a more favourable prognosis and outcome to the patient.