Seyed Reza Yahyazadeh
1 
, Tayebeh Soleymanian
2* 1 Nephrology and Urology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Nephrology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Emphysematous pyelonephritis (EPN) is a rare and ominous necrotizing kidney infection mainly involving diabetic patients. While prompt medical therapy with antibiotic and percutaneous catheter drainage is mainstay of management, nephrectomy should remain for unresponsiveness situations with poor prognostic factors. We introduced the clinical course of an old male presented with bilateral EPN which was successfully treated without nephrectomy regardless of various risk factors such as thrombocytopenia, impaired consciousness, and acute renal failure.
Implication for health policy/practice/research/medical education:
We treated a severe case of bilateral emphysematous pyelonephritis with circulatory/liver failure by intensive medical management including proper antibiotic therapy and percutaneous catheter drainage, rapid control of hyperglycemia, volume repletion, and treatment of renal failure complications with a full recovery and good outcome. Therefore, nephrectomy should be maintained for the failure of conservative management.
Please cite this paper as: Yahyazadeh SR, Soleymanian T. Successful non-surgical management of bilateral emphysematous pyelonephritis despite adverse prognostic factors; report of a case and review of the literature. J Nephropathol. 2020;9(3):e29. DOI: 10.34172/jnp.2020.29.