Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, IndiaFulltext PDF
Emphysematous pyelonephritis is an acute necrotizing infection of the kidney, produced by gasforming bacterial and fungal infections. The magnitude of the problem, its impact on the kidney, ultimate kidney salvage ability has seen a drastic improvement in the last two decades. From the time Schultz coined this term in 1962, the concepts involving diagnosis and management have been constantly evolving. Diabetes mellitus continues to wreak havoc by allowing a strong platform for the gas-forming organisms to proliferate and destroy the renal parenchyma. Infective organisms range from gram-negative bacteria to Cryptococcus and Candida species. Early nephrectomy, which was one of the life-saving measures two decades back, has almost become obsolete now. Minimally invasive procedures including double-J placement, percutaneous nephrostomy and percutaneous drainage have become the standard of care in most patients. Assessment of prognosis and choosing appropriate treatment is largely based on the prognostic scoring systems and risk stratifying strategies. With improved diagnostic methods, high awareness amongst treating physicians and early and prompt treatment has made EPN a manageable disease with rapid recovery and less mortality.
Emphysematous pyelonephritis; Nephrostomy; Double J stent; Candida albicans
Krishnamoorthy S. Emphysematous Pyelonephritis: Changing Trends in Last Two Decades. Clin Surg. 2021; 6: 3243..