Emphysematous Pyelonephritis (EPN) Differential Diagnoses

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

Acute pyelonephritis also has a presentation similar to that of emphysematous pyelonephritis (EPN). Another septic condition, xanthogranulomatous pyelonephritis, which is usually associated with stones in a nonfunctioning kidney with a severe gram-negative infection, is very similar in presentation to EPN .

Xanthogranulomatous pyelonephritis may also produce gas in the renal parenchyma and perinephric space, but generally not to the degree observed with EPN. The treatment of xanthogranulomatous pyelonephritis is strictly surgical; early nephrectomy is indicated because the kidney is already nonfunctional and is not worth saving.

Differential Diagnoses