Title: Clinical Profile of Emphysematous Pyelonephritis in Diabetics
Authors: C G Jijumon, Srikantan Sreedharan Pillai
Introduction: Emphysematous pyelonephritis is a rare but potentially life threatening necrotising renal parenchymal infection characterised by the production of intraparenchymal gas. It is exclusively found in Diabetic patients with a female pre ponderance. In the past, standard treatment was nephrectomy of the affected kidney. The situation has changed dramatically in recent years with CT scan based diagnosis and advancements in multidisciplinary intensive care of sepsis syndrome and MODS. Now the mortality rates has declined to 20%-25%.
Objectives: To study the clinical profile and etiology of emphysematous pyelonephritis among Diabetic patients
Materials and Methods: 50 Diabetic patients with emphysematous pyelonephritis were studied. Clinical profile including etiology were studied.
Results: EPN was more in the elderly diabetics. 44% of the patients were above 65 years. Females constituted the majority (98%). E.Coli was the commonest organism isolated (78.9%) followed by Klebsiella. The overall survival rate was 90%.
Conclusions: EPN was more common in elderly female diabetics. The overall survival rate with medical treatment was good. Mortality was more in patients with bilateral EPN, thrombocytopenia, shock, renal failure and altered mental status.
Keywords: EPN. MODS.