Stein J P, Spitz A, Elmajian D A, Esrig D, Freeman J A, Grossfeld G D, Ginsberg D A, Skinner D G
Department of Urology, University of Southern California, Los Angeles 90033, USA.
Urology. 1996 Jan;47(1):129-34. doi: 10.1016/s0090-4295(99)80399-9.
Emphysematous pyelonephritis is a rare, rapidly progressive, life-threatening infection of the renal parenchyma. It most commonly is unilateral, is found almost exclusively in diabetics, is associated with gas-forming coliform bacteria, and is characterized by the presence of gas within the renal parenchyma. Early aggressive therapy (combined medical and surgical) is the hallmark of successful treatment. A high index of suspicion coupled with radiographic imaging is essential to make a timely diagnosis and guide therapeutic intervention. Bilateral emphysematous pyelonephritis is an even more rare phenomena, with only 14 reported cases in the English literature and is associated with a high patient mortality. We herein present an additional case and review the literature as it pertains to bilateral emphysematous pyelonephritis. Appropriate care requires aggressive combined medical and surgical therapy in an attempt to preserve renal function without increased mortality.
气肿性肾盂肾炎是一种罕见的、进展迅速、危及生命的肾实质感染。它最常见为单侧性，几乎仅见于糖尿病患者，与产气大肠菌有关，其特征是肾实质内存在气体。早期积极治疗（药物与手术联合）是成功治疗的关键。高度的怀疑指数加上影像学检查对于及时诊断和指导治疗干预至关重要。双侧气肿性肾盂肾炎是一种更为罕见的现象，英文文献中仅报道了14例，且与患者高死亡率相关。我们在此报告另一例病例，并就双侧气肿性肾盂肾炎相关文献进行综述。恰当的治疗需要积极的药物与手术联合治疗，以在不增加死亡率的情况下尽力保留肾功能。
