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Organo Oficial de la Sociedad Mexicana de Urología

2006, Number 2

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Rev Mex Urol 2006; 66 (2)

Emphysematous pyelonephritis

Moreno RR, Viveros CC, Lugo GJA, Cruz TJ, Díaz EMC

Language: Spanish
References: 37
Page: 74-82
PDF size: 339.08 Kb.


ABSTRACT

Background. Emphysematous pyelonephritis is a rare, severe gas forming infection of the renal parenchyma and adjacent areas. The radiological classification and adequate therapeutic regimen are controversial, and the prognostic factors remain uncertain.
Methods. A review of twenty case files of patients diagnosed and treated for emphysematous pyelonephritis at the Urology Department of the Hospital Juarez of Mexico between January 01 of 2000 and December 31 of 2004.
Results. The mean age of patients was 52.75 years. 95% were diabetic. 15% had urinary obstruction. 70% presented the classic triad of fever, pain and lower urinary irritative syndrome. Escherichia coli was the most frequently isolated microorganism in urine cultures (85%). The poor prognostic factors identified were altered state of consciousness, shock, and thrombocitopenia with an exact Fisher test p 0.0002 and acute renal insufficiency with p 0.013.
Conclusions. The associated factors to the development of emphysematous pyelonephritis are diabetes mellitus, urinary tract infection and urinary obstruction. The use of a tomographical imaging study provides valuable information and is feasible in our environment. Escherichia coli was the most frequent pathogen; the poor prognostic factors are an altered state of consciousness, shock, thrombocitopenia and acute renal insufficiency.


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