Indications for Percutaneous Drainage in Patients with Huang Class 3B Emphysematous Pyelonephritis: A Case Report and Literature Review

Emphysematous pyelonephritis (EPN) is a severe urinary tract infection common in patients with diabetes. Nephrectomy is recommended when the Huang classification is ≥3B. We herein report a case in which nephrectomy was avoided using antimicrobial agents and percutaneous drainage (PCD). A 59-year-old...

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Bibliographic Details
Published in:Internal Medicine 2023/10/01, Vol.62(19), pp.2871-2876
Main Authors: Fukunaga, Shohei, Naito, Yumi, Hoshino, Yuki, Oba, Masafumi, Kawanishi, Miharu, Yoshikane, Kaori, Egawa, Masahiro, Ito, Takafumi, Tanabe, Kazuaki
Format: Article
Language:English
Subjects:
Antimicrobial agents
Case Report
Case reports
Classification
Diabetes mellitus
Emphysema
emphysematous pyelonephritis
Huang classification
Internal medicine
Literature reviews
Nephrectomy
percutaneous drainage
Pyelonephritis
Risk factors
Urinary tract
Wound drainage
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Summary:Emphysematous pyelonephritis (EPN) is a severe urinary tract infection common in patients with diabetes. Nephrectomy is recommended when the Huang classification is ≥3B. We herein report a case in which nephrectomy was avoided using antimicrobial agents and percutaneous drainage (PCD). A 59-year-old man was diagnosed with EPN (Huang classification 3B). The causative bacteria were Escherichia coli. Despite high-risk factors, EPN was cured with kidney preservation and PCD because the emphysema and abscess were not extensive. Thus, PCD should be considered in patients with Huang Class 3B EPN and high-risk factors if emphysema and abscess are not extensive.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.0694-22