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| CASE REPORTS |
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| Year : 2005 | Volume
: 51
| Issue : 4 | Page : 324-325 |
Emphysematous pyelonephritis: A consequence of adenocarcinoma of urinary bladder in a nondiabetic patient
I Singh1, SS Pachisia2, S Kumar2, VK Arora3, P Kumar1
1 Departments of Urology, University College of Medical Sciences, University of Delhi, G.T.B. Hospital, Delhi, India
2 Departments of Surgery, University College of Medical Sciences, University of Delhi, G.T.B. Hospital, Delhi, India
3 Departments of Pathology, University College of Medical Sciences, University of Delhi, G.T.B. Hospital, Delhi, India
Correspondence Address:
I Singh
Departments of Urology, University College of Medical Sciences, University of Delhi, G.T.B. Hospital, Delhi
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 16388179 
Emphysematous pyelonephritis (EP) is a life threatening condition of acute necrotising renal parenchymal infection that encompasses a much wider spectrum of complicated urinary tract infections such as renal abscesses, emphysematous pyelitis, pyelonephritis, acute renal papillary necrosis, and sepsis. We report an unusual case of adenocarcinoma bladder in a middle aged nondiabetic patient, presenting with EP. Emphysematous pyelonephritis was the initial symptom in this case with an underlying carcinoma of the bladder. The role of imaging is prime in management of such cases, if an early diagnosis is to be made and a potentially devastating outcome is to be avoided. The literature regarding EP has been reviewed and discussed.
The goals of managing EP should be (1) early institution of parenteral antibiotics and a (2) a staged nephrectomy (preceded by a temporary percutaneous drainage particularly with antibiotic resistant septicemia) so as to maximize survival rather than proceeding directly to emergency nephrectomy.
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