Seker Kamil Gokhan, Arikan Yusuf, Cetin Seker Yurdagul, Ozlu Deniz Noyan, Evren Ismail
Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, TUR.
Emergency Medicine, Muş State Hospital, Muş, TUR.
Cureus. 2020 May 27;12(5):e8307. doi: 10.7759/cureus.8307.
Emphysematous urinary tract infections (UTI) are life-threatening conditions caused by gas-forming organisms. Emphysematous pyelitis (EP) is a rare, acute bacterial UTI characterized by gas formation only in the renal collecting system. Extracorporeal shock wave lithotripsy (ESWL) treatment was performed for 10-mm sized stone in the left renal pelvis in an 81-year-old female patient with no known comorbidities other than hypertension. In the 10th hour following ESWL treatment, the patient referred to the emergency department with fever and left flank pain. Gas was noticed in the left renal collecting system in non-contrast computed tomography (NCCT). A wide spectrum antibiotic was given to the patient due to EP diagnosis and a nephrostomy catheter was placed in the left renal pelvis. EP should be considered in the patient with fever and flank pain after ESWL and NCCT should be performed for further examination. Quick diagnosis, examination and treatment of these patients in the emergency department are important.
气肿性尿路感染（UTI）是由产气微生物引起的危及生命的疾病。气肿性肾盂炎（EP）是一种罕见的急性细菌性UTI，其特征是仅在肾集合系统中形成气体。一名81岁女性患者，除高血压外无其他已知合并症，因左肾盂内10毫米大小的结石接受了体外冲击波碎石术（ESWL）治疗。在ESWL治疗后的第10小时，患者因发热和左侧腰痛被送往急诊科。非增强计算机断层扫描（NCCT）显示左肾集合系统中有气体。由于诊断为EP，给予患者广谱抗生素，并在左肾盂放置了肾造瘘导管。对于ESWL后出现发热和腰痛的患者应考虑EP，并应进行NCCT进一步检查。在急诊科对这些患者进行快速诊断、检查和治疗很重要。
