eMedicine Specialties > Urology > Infections and Related Inflammatory Conditions

Emphysematous Pyelonephritis: Follow-up

Author: Sugandh Shetty, MD, Consulting Staff, Department of Urology, William Beaumont Hospital
Contributor Information and Disclosures

Updated: May 1, 2008

Outcome and Prognosis

Patients with emphysematous pyelonephritis (EPN) should be treated with aggressive medical management and prompt surgical intervention. Conservative treatment, such as percutaneous drainage with antibiotics, should be reserved only for patients with unilateral EPN or bilateral EPN or those with compromised renal function. Early cases of patients with EPN who have gas in the collecting system alone and who are otherwise in stable condition may be treated with antibiotics and drainage. Although nephrectomy offers the best outcome, a trial of conservative treatment with drainage should be offered. However, if access to percutaneous drainage or internal stenting is not available, nephrectomy should be considered after stabilization is achieved.

Management is based on the clinical and laboratory findings. If the patient is stable, conservative treatment with antibiotics and drainage should be tried. If the patient has gas in the renal parenchyma and perinephric tissues along with significant exudate, initial percutaneous drainage should be given a chance. Saving nephrons and the patient's life should be weighed based on the clinical situation, response to treatment, and available facilities.

 


More on Emphysematous Pyelonephritis

Overview: Emphysematous Pyelonephritis
Workup: Emphysematous Pyelonephritis
Treatment: Emphysematous Pyelonephritis
Follow-up: Emphysematous Pyelonephritis
Multimedia: Emphysematous Pyelonephritis
References
Further Reading
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References

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Further Reading

For additional information, visit Medscape’s Diabetic Microvascular Complications Resource Center and Stone Disease Resource Center.

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Keywords

emphysematous pyelonephritis, emphysematous pyelitis, gas-forming infection of the urinary tract, EPN, renal parenchyma infection, urinary tract infection, UTI, pneumaturia, renal emphysema, pneumo-nephritis, pneumonephritis, diabetes, xanthogranulomatous pyelonephritis

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Contributor Information and Disclosures

Author

Sugandh Shetty, MD, Consulting Staff, Department of Urology, William Beaumont Hospital
Sugandh Shetty, MD is a member of the following medical societies: American Urological Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Ajay K Singh, MB, MRCP, MBA, Associate Professor of Medicine, Director of Dialysis, Department of Medicine, Harvard Medical School; Clinical Chief of Renal Division, Brigham and Women's Hospital
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf, Jr, MD, FACS, David A Bloom Professor of Urology, Director, Division of Minimally Invasive Urology, Department of Urology, University of Michigan Medical Center
J Stuart Wolf, Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, and Society of University Urologists
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Chief Editor

Edward David Kim, MD, FACS, Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center
Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association
Disclosure: Lilly Consulting fee Consulting

 
 
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