Emphysematous pyelonephritis with left renal vein thrombosis-case report successfully treated by conservative methods

Abstract

Presently emphysematous pyelonephritis is a rare but life-threatening disease, mostly seen in patients with urinary tract obstr uc- tion and diabetes mellitus. It is characterized by the production of gas and necrosis in the renal parenchyma, collecting systems, and perinephritic tissue. Radiologically, the Huang and Tseng classification is used to categorize the severity of the disease. Our case was 49 years old female pre- senting with unconsciousness, fever and bilateral Grade 3 lower extremity eodema one week after left percutaneous nephrolithotomy procedure because of urinary tract stone. Abdominal computerized tomography scan showed renal parenchymal and perinephritic tissue necrosis with the production of gas and renal vein thrombosis which was in accordance with Huang and Tseng classification Grade 3A. We treated our patient with the appropriate antibiotic, enoxaparin sodium, strict glycemic control, and supportive treatment without any surgical intervention or nephrectomy.