van der Kamp R, Nienhuis J E, Rosekrans P A, Dees A
Ikazia Ziekenhuis, Rotterdam.
Ned Tijdschr Geneeskd. 2000 Apr 8;144(15):713-6.
A 55-year-old man with diabetes mellitus was sick with shivering, abdominal pain and Escherichia coli in blood and urine cultures; a 40-year-old woman with asthmatic bronchitis had abdominal pain and anaemia. Both had renal dysfunction and the CT scan showed hydronephrosis with a perirenal inflammatory infiltrate and gas in the right and left renal pelvis, respectively. The man had a difficult recovery after treatment with antibiotics and percutaneous drainage. In the woman, a calculus obstructed the pyelo-ureteral passage; the resected kidney contained a squamous cell carcinoma. She was operated, received chemotherapy and recovered. Emphysematous pyelonephritis is a rare, severe disease. Percutaneous drainage and, if necessary, nephrectomy are paramount in the treatment. The condition is observed mostly in patients with diabetes mellitus or obstruction of the urinary tract.
一名55岁的糖尿病男性患者出现寒战、腹痛,血培养和尿培养发现大肠杆菌;一名40岁的哮喘性支气管炎女性患者有腹痛和贫血症状。两人均有肾功能不全,CT扫描显示肾积水,分别在左右肾盂有肾周炎性浸润及气体。该男性患者经抗生素治疗及经皮引流后恢复过程艰难。该女性患者,一枚结石阻塞了肾盂输尿管通道;切除的肾脏中发现了鳞状细胞癌。她接受了手术、化疗并康复。气肿性肾盂肾炎是一种罕见的严重疾病。经皮引流,必要时行肾切除术是治疗的关键。这种情况多见于糖尿病患者或尿路梗阻患者。