Case Reports in Clinical Practice 2016. 1(4):110-114.

Conservative Management of Emphysematous Pyelonephritis in Transplantation
Shahram Gooran, reza dehghaniathar, Gholamreza Pourmand


Emphysematous  pyelonephritis is a urologic emergency condition characterized by an acute  and severe necrotizing parenchymal and perirenal infection caused by Gas-forming uropathogens. predisposing  factors include diabetes,immunosuppression conditions, urinary tract obstruction associated with urinary calculi or papillary necrosis and significant renal functional impairment. The overall mortality rate has been reported to be between19%to 43% and few cases in kidney allograft have been reported. All of the documented cases of emphysematous pyelonephritis have occurred in adults Juvenile diabetic patients do not appear to be at risk. Female are affected more often than male.we report A 66-year-old  diabetic man with ESRD (end stage renal disease) received deceased renal transplant two mounts after transplantation admitted in hospital , with complain of reduced urine out-put an increase in serum creatinine (Cr) level,fever and abdominal pain.. The patient was treated with 250 mg intravenous imipenem q12h and 1 g intravenous vancomycin  and patient take under hemodialysis  every other day for one week, An ultrasound guided percutaneous  nephrostomy accomplished  and  fortunately he did  considerably respond clinically and radiologically the transplanted kidney  was saved.


Emphysematous pyelonephritis; End-stage renal disease; Percutaneous nephrostomy; Renal transplantation

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Mohsin N, Budruddin M, Lala S, Al-Taie S. Emphysematous pyelonephritis: A case report series of four patients with review of literature. Ren Fail 2009; 31(7): 597-601.

Michaeli J, Mogle P, Perlberg S, Heiman S, Caine M. Emphysematous pyelonephritis. J Urol 1984; 131(2): 203-8.

Huang JJ, Tseng CC. Emphysematous pyelonephritis: Clinicoradiological classification, management, prognosis, and

pathogenesis. Arch Intern Med 2000; 160(6): 797-805.

Boltan LE, Randall H, Barri YM. Iatrogenic emphysematous pyelonephritis in a renal transplant patient. Transpl Infect Dis 2008; 10(6): 409-12.

Kolla PK, Madhav D, Reddy S, Pentyala S, Kumar P, Pathapati RM. Clinical profile and outcome of conservatively managed emphysematous pyelonephritis. ISRN Urol 2012; 2012: 931982.

Falagas ME, Alexiou VG, Giannopoulou KP, Siempos II. Risk factors for mortality in patients with emphysematous pyelonephritis: A metaanalysis. J Urol 2007; 178(3 Pt 1): 880-5.

Fujita S, Watanabe J, Reed AI, Hemming AW, Solis D, Netzel TC, et al. Case of emphysematous pyelonephritis in a renal allograft. Clin Transplant 2005; 19(4): 559-62.

Al-Geizawi SM, Farney AC, Rogers J, Assimos D, Requarth JA, Doares W, et al. Renal allograft failure due to emphysematous pyelonephritis: Successful non-operative management and proposed new classification scheme based on literature review. Transpl Infect Dis 2010; 12(6): 543-50.

Piracha K, Darras F., Nord E, Wadhwa N. Emphysematous pyelonephritis in a renal transplant patient. Open J Nephrol 2014; 4(2): 86-91.

Pesavento TE. Kidney transplantation in the context of renal replacement therapy. Clin J Am Soc Nephrol 2009; 4(12): 2035-9.

Cheng YT, Wang HP, Hsieh HH. Emphysematous pyelonephritis in a renal allograft: Successful treatment with percutaneous drainage and nephrostomy. Clin Transplant 2001; 15(5): 364-7.

Schmidt S, Foert E, Zidek W, van der Giet M, Westhoff TH. Emphysematous pyelonephritis in a kidney allograft. Am J Kidney Dis 2009; 53(5): 895-7.

Strofilas A, Manouras A, Lagoudianakis EE, Kotzadimitriou A, Pappas A, Chrysikos I, et al. Emphysematous pyelonephritis, a rare cause of pneumoperitoneum: A case report and review of literature. Cases J 2008; 1(1): 91.


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