International Journal of Clinical Urology


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Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature

Introduction: Emphysematous pyelonephritis is a rare and serious medical-surgical condition. Emergency nephrectomy is the standard treatment for forms that respond poorly to medical therapy, in conjunction with drainage of the upper excretory tract. Case report: This is a case of emphysematous pyelonephritis in a 54-year-old female patient who had presented with acute pyelonephritis, left renal colic and hyperactivity syndrome. A non-injected abdominopelvic CT scan revealed a globular, dedifferentiated left kidney with a diffuse aortic component. The right kidney was unremarkable. In intensive care, despite placement of a double JJ tube and antibiotic therapy with amikacin and cefotaxime, the patient's hemodynamic and neurological status continued to deteriorate, necessitating intubation. After 24 hours of well-managed treatment with no improvement, nephrectomy was performed in the setting of emphysematous destruction of the left kidney and persistent latent shock. Based on this observation and a review of the literature, we describe the clinical and radiological features, as well as the various diagnostic and therapeutic means of this condition. Conclusion: the diagnosis of emphysematous pyelonephritis should be suspected in the following cases: the presence of severe acute pyelonephritis, with no improvement in clinical condition despite well-conducted medical treatment or percutaneous drainage, or associated with signs of severity, particularly in diabetics, radical treatment is envisaged after failure of drug therapy.

Nephrectomy, Emphysematus Pyelonephritis, Diabtic, Hospital National Ignace Deen, Emergengy

Bah Mamadou Bissiriou, Barry Mamadou Madiou, Barry Mamadou Dian, Diallo Thierno Oumar, Sow Thierno Amadou Oury, et al. (2023). Nephrectomy in the Management of Emphysematous Pyelonephritis: Analysis of a Case and Review of the Literature. International Journal of Clinical Urology, 7(2), 53-56.

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Abdelouahed Lasri1, Amine Saouli, Othmane Yddoussalah Emphysematous pyelonephritis with favorable evolution after medical treatment: about 3 observations Pan African Medical Journal. 2018; 30: 223.
2. E. Kaiser, R. Fournier Emphysematous pyelonephritis: diagnosis and treatment Annales d'urologie 39 (2005) 49-60.
3. Driss TOUITI, Emmanuel DELIGNE, Lionel BADET, Marc COLOMBEL, Xavier MARTIN, Albert GELET La pyélonéphrite emphysémateuse: à propos de 3 observations Progrès en Urologie (2001), 11, 703-706.
4. Sarf I, Meziane A, Dahami Z, Dakir M, Jaoual A, Bennani S, et al. Emphysematous pyelonephritis: review of the literature concerning a case report. Ann Urol 2003; 37: 54-6.
5. WanYL, Lo SK, Bullard MJ, Chang PL, Lee TY. Predictors of outcome in emphysematous pyelonephritis. J Urol 1998; 159: 369-73.
6. Grimaldi A. Diabète de type 2: l'épidémie annoncée est en cours. Rev Prat. 2003; 53 (10): 1067-8.
7. R. Kapoor, K. Muruganandham, A. K. Gulia, M. Singla, S. Agrawal, A. Mandhani, A. Srivastava, Predictive factors for mortality and need for nephrectomy in patients with emphysematous pyelonephritis, BJU Int. 105 (7) (2010) 986-989.
8. Miane D, Beatrix O, Bregion M, Sabbah P, Altobelli A, Boyer C. Pyélonéphrite emphysémateuse. Complication rare du diabète sucré. Med Armees. 1996; 24: 583-6.
9. K. Aswathaman, G. Gopalakrishnan, L. Gnanaraj, N. K. Chacko, N. S. Kekre, A. Devasia, Emphysematous pyelonephritis: outcome of conservative management, Urology 71 (6) (2008) 1007–1009.
10. Emphysematous cystitis: illustrative case report and review of the literature. Grupper M, Kravtsov A, Potasman I. Medicine (Baltimore) 2007; 86: 47–53.
11. Hudson MA, Weyman PJ, Van Der Vliet AH, Catalona WJ. Emphysematous pyelonephritis: Successful management by percutaneous drainage. J Urol. 1986; 136 (4): 884 68-. Article 11 et 14.
12. P. Dutta, A. Bhansali, S. K. Singh, K. L. Gupta, M. H. Bhat, S. R. Masoodi, Y. Kumar, Presentation and outcome of emphysematous renal tract disease in patients with dabetes mellitus, Urol. Int. 78 (1) (2007) 13-22.
13. Pyélonéphrite emphysémateuse fulminante à Candida glabrata dans une allogreffe de rein. Cases-Corona C, Shabaka A, Gonzalez-Lopez A, Martin-Segarra O, Moreno de la Higuera MA, Lucena R, Fernandez-Juarez G. Nephron. 2020; 144: 304-309.
14. Moez Rahoui *, Yassine Ouanes, Kays Chaker, Mokhtar Bibi Predictive factors for failure of conservative management in patients with emphysematous pyelonephritis Annals of Medicine and Surgery 78 (2022) 103930.
15. M. E. Falagas, V. G. Alexiou, K. P. Giannopoulou, Siempos II, Risk factors for mortality in patients with emphysematous pyelonephritis: a meta-analysis, J. Urol. 178 (2007) 880–885.
16. Aswathaman, G. Gopalakrishnan, L. Gnanaraj, N. K. Chacko, N. S. Kekre, A. Devasia, Emphysematous pyelonephritis: outcome of conservative management, Urology 71 (6) (2008) 1007–1009.
17. Shokeir AA, El-Azab M, Mohsen T, El-Diasty T. Emphysema tous pyelonephritis: a 15-year experience with 20 cases. Urology 1997; 49: 343–6. 15.
18. Hooton T. Urinary tract infection in adults. In: JurgeonF, Johnson RJ, Feehally J, editors. Comprehensive Clinical Nephrology. 4thed. Philadelphia: Mosby, Elsevier Inc; 2010. p. 638-9.
19. Huang JJ, Tseng CC. Emphysematous pyelonephritis: Clinicoradiological classification, management, prognosis and pathogenesis. Arch Intern Med. 2000; 160 (6): 797 805.