Emphysematous Pyelonephritis (EPN) Differential Diagnoses

Updated: Mar 12, 2021
  • Author: Sugandh Shetty, MD, FRCS; Chief Editor: Edward David Kim, MD, FACS  more...
  • Print

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.

Gas confined to the renal pelvis differentiates emphysematous pyelitis (EP) from EPN. These disorders share a similar pathophysiology and are both associeted with diabetes mellitius, the treatment differs. [21]

Differential Diagnoses