Sarf I, Meziane A, Dahami Z, Dakir M, Jaoual A, Bennani S, el Mrini M, Benjelloun S
Service d'urologie, centre hospitalier universitaire Ibn Rochd, 18, rue Ain-Harrouda (Ex rue Jeanne-d'Arc), résidence walili, appartement 13, 7e étage, Casablanca, Maroc.
Ann Urol (Paris). 2003 Apr;37(2):54-6. doi: 10.1016/s0003-4401(03)00005-6.
Emphysematous pyelonephritis is defined as the presence of gas-producing bacteria in the kidney and in peri-nephretic areas. Even if it is rare, the mortality rate of this affection is between 50% and 90%. The E. coli is responsible in 60% of the cases. We report a case of a 50 years old male patient, with under diagnosed diabetics, how is admitted with pains in the left flank, fever, troubled urine, hematuria and worsening of general state. The diagnostic of emphysematous pyelonephritis was confirmed by CT Scan. In spite of adapted antibiotherapy to the renal function, insulinotherapy and correction of hydro-electrolytic troubles, the patient died with septic shock associated to digestive bleeding. Based on this case and a review of the literature, the authors describe the different features of this disease. Only an urgent nephrectomy after a short reanimation can improve the prognostic.
气肿性肾盂肾炎的定义为肾脏及肾周区域存在产气细菌。尽管该病罕见,但其死亡率在50%至90%之间。60%的病例由大肠杆菌引起。我们报告一例50岁男性患者,患有未得到充分诊断的糖尿病,因左侧腰痛、发热、尿液异常、血尿及全身状况恶化入院。气肿性肾盂肾炎的诊断经CT扫描得以证实。尽管采取了适应肾功能的抗生素治疗、胰岛素治疗及水电解质紊乱的纠正措施,但患者仍死于与消化道出血相关的感染性休克。基于该病例及文献回顾,作者描述了该疾病的不同特征。只有在短时间复苏后紧急进行肾切除术才能改善预后。