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VOLUME 24 , ISSUE 4 ( April, 2020 ) > List of Articles

LETTER TO THE EDITOR

Emphysematous Pyelonephritis Presenting as Pneumomediastinum: A Rare Case Scenario

Vilvapathy Senguttuvan Karthikeyan, Venugopal Mohan, Jayaprakash Narayanan, Aswathaman Karthikeyan

Keywords : Emphysematous pyelonephritis, Pneumomediastinum, Urosepsis

Citation Information : Karthikeyan VS, Mohan V, Narayanan J, Karthikeyan A. Emphysematous Pyelonephritis Presenting as Pneumomediastinum: A Rare Case Scenario. Indian J Crit Care Med 2020; 24 (4):281-282.

DOI: 10.5005/jp-journals-10071-23409

License: CC BY-NC 4.0

Published Online: 01-08-2019

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Emphysematous pyelonephritis (EPN) is characterized by fulminant necrotizing infection of the kidney and perirenal tissues. Emphysematous pyelonephritis presenting as pneumomediastinum is quite rare. A 65-year-old gentleman presented to us with respiratory failure on ventilator support and uncontrolled sugars. He had fever with chills, abdominal pain, and breathlessness. He was evaluated and computed tomography showed right Huang et al. class 3 EPN with pneumomediastinum. He also had renal failure, respiratory distress syndrome, and metabolic acidosis. Pigtail drainage of right EPN was performed. He succumbed to the disease despite treatment. This case highlights the rare presentation of EPN as pneumomediastinum.


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  1. Park SH, Hong HP, Kim MC, Ko YG. Emphysematous pyelonephritis associated with pneumoperitoneum and pneumomediastinum: a case report. Journal of The Korean Society of Emergency Medicine 2005;16(3):398–402. Available from: http://www.jksem.org/journal/view.php?number=1099. Last accessed: 03/04/20.
  2. Ting KH, Lin KH, Chang CC. Emphysematous pyelonephritis: presenting with pneumomediastinum. Am J Emerg Med 2006;24(3):350–352. DOI: 10.1016/j.ajem.2005.09.015.
  3. Wang YC, Wang JM, Chow YC, Chiu AW, Yang S. Pneumomediastinum and subcutaneous emphysema as the manifestation of emphysematous pyelonephritis. Int J Urol 2004;11(10):909–911. DOI: 10.1111/j.1442-2042.2004.00919.x.
  4. Yadav MK, Bhatia A, Bhalla A, Khandelwal N. Emphysematous pyelonephritis with air in the renal vein and septic emboli in the lungs: a rare presentation. Saudi J Kidney Dis Transpl 2014;25(5):1086–1087. DOI: 10.4103/1319-2442.139948.
  5. Cheng KC, Lin TC, Tsan YT, Hu SY, Wang LM. Pneumomediastinum as first manifestation of emphysematous pyelonephritis in a patient who is non-diabetic. BMJ Case Rep 2009;2009(Jul 14 1):pii: bcr05.1873. DOI: 10.1136/bcr.05.2009.1873.
  6. Karthikeyan VS, Manohar CMS, Mallya A, Keshavamurthy R, Kamath AJ. Clinical profile and successful outcomes of conservative and minimally invasive treatment of emphysematous pyelonephritis. Cent European J Urol 2018;71(2):228–233. DOI: 10.5173/ceju.2018.1639.
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