Emphysematous Pyelonephritis (EPN) Clinical Presentation

Updated: Nov 13, 2017
  • Author: Sugandh Shetty, MD, FRCS; Chief Editor: Edward David Kim, MD, FACS  more...
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Presentation

History and Physical Examination

Patients typically present with fever (79%), abdominal or flank pain (71%), nausea and vomiting (17%), dyspnea (13%), acute renal impairment (35%), altered sensorium (19%), shock (29%), and thrombocytopenia (46%).

Crepitus over the flank area may occur in advanced cases of EPN. Pneumaturia is uncommon unless emphysematous cystitis is present. Subcutaneous emphysema and pneumomediastinum have also been reported in a case of EPN. [3] Comorbidities include alcoholism, malnourishment, renal calculi, and diabetic ketoacidosis.