Picron B, Mauerhoff T, Farchakh E, Wese F X
Service d'Endocrinologie et de Nutrition, Cliniques Universitaires Saint-Luc, U.C.L., Bruxelles.
Acta Clin Belg. 1991;46(2):94-9. doi: 10.1080/17843286.1991.11718149.
We report the history of a 65-year-old woman, diabetic for 25 years who presented progressive alteration of consciousness with hyperthermia, right upper quadrant pain and vomiting. Bacteriological and radiographic investigations, especially computerized tomography scan of the abdomen, led to the diagnosis of emphysematous pyelonephritis caused by Escherichia coli. Despite a large spectrum antibiotic therapy and surgical drainage of the gas collection, the patient remained septic. An emergency nephrectomy was eventually performed. We review the characteristics of emphysematous pyelonephritis. Early diagnosis is essential because without early nephrectomy mortality rates reach 75%.
我们报告了一名65岁女性的病史，她患有糖尿病25年，出现意识进行性改变，伴有高热、右上腹疼痛和呕吐。细菌学和影像学检查，尤其是腹部计算机断层扫描，确诊为大肠杆菌引起的气肿性肾盂肾炎。尽管进行了广谱抗生素治疗和气性积液的外科引流，但患者仍发生败血症。最终进行了急诊肾切除术。我们回顾了气肿性肾盂肾炎的特点。早期诊断至关重要，因为不进行早期肾切除术死亡率可达75%。
