Successful nephrectomy after a failure of non-surgical treatment in emphysematous pyelonephritis: A case report

• Published in: Heliyon
• Main Author: Chandrasekaran T.; Chong S.; Gan D.E.Y.; Zainal Abidin Z.A.; Hayati F.
• Format: Article
• Language: English
• Published: Elsevier Ltd 2022
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140259223&doi=10.1016%2fj.heliyon.2022.e11070&partnerID=40&md5=36365db58deece250205a46109178395

Emphysematous pyelonephritis (EP) is an uncommon condition involving acute severe necrotising infection in the renal parenchyma, perinephric space and collecting system, with a mortality rate of up to 13%. A 62-year-old male with poorly controlled diabetes mellitus presented with severe epigastric pain and shortness of breath for three days. A computed tomography scan revealed class 3B EP, which failed medical therapy and percutaneous drainage. He underwent a nephrectomy and achieved an excellent clinical recovery. Septic shock and uncontrolled diabetes mellitus are two risk factors that lead to a poorer prognosis. Class 3B EP with failed medical therapy and percutaneous drainage would benefit from nephrectomy. © 2022 The Author(s)