Cherif Mohamed, Kerkeni Walid, Bouzouita Abderrazak, Selmi Mohamed Slim, Derouiche Amine, Ben Slama Mohamed Riadh, Chebil Mohamed
Service d'urologie, Hopital Charles Nicolle de Tunis, Tunisie.
Tunis Med. 2012 Oct;90(10):725-9.
Emphysematous pyelonephritis is an uncommon, necrotizing bacterial infection of the kidney. It is a severe, life threatening affection.
To study the epidemiological, clinical, biological, bacteriological and radiological features of this affection, and to describe its therapeutic management and prognostic characteristics.
We conducted a retrospective study including 30 patients who were treated for an emphysematous pyelonephritis, in Charles Nicolle hospital department of urology, from 1987 to 2009.
Emphysematous pyelonephritis generally affects adults. It is especially favored by diabetes and urinary tract obstruction. Escherichia coli is the main causative agent. Uroscan is the key of diagnosis. It is both medical and surgical emergency; the treatment combines intensive care with appropriate antibiotics and often drainage. Nephrectomy may be necessary from the outset, or after drainage failure. Prognosis is poor, with a high mortality rate (23 %), in our series.
Management of emphysematous pyelonephritis poses real problems. This affection is still threatening, despite of advances in intensive care.
气肿性肾盂肾炎是一种罕见的肾脏坏死性细菌感染。它是一种严重的、危及生命的疾病。
研究该疾病的流行病学、临床、生物学、细菌学和放射学特征，并描述其治疗管理和预后特征。
我们进行了一项回顾性研究，纳入了1987年至2009年在查尔斯·尼科勒医院泌尿外科接受气肿性肾盂肾炎治疗的30例患者。
气肿性肾盂肾炎通常影响成年人。糖尿病和尿路梗阻尤其易引发该病。大肠杆菌是主要病原体。尿路造影是诊断的关键。它既是内科急症也是外科急症；治疗方法包括重症监护、使用适当的抗生素，且常需引流。可能一开始就需要进行肾切除术，或者在引流失败后进行。在我们的系列研究中，预后较差，死亡率较高（23%）。
气肿性肾盂肾炎的治疗存在实际问题。尽管重症监护有所进展，但这种疾病仍然具有威胁性。
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