Venous gas caused by emphysematous pyelonephritis: a case report and review of literature
Abstract Background Emphysematous pyelonephritis (EPN) is a potentially life-threatening disease caused by a gas-producing necrotizing bacterial infection that involves the renal parenchyma, collecting system, and/or perinephric tissue. EPN is often complicated by a previous diagnosis of diabetes me...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-09-01
|
| Series: | BMC Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12894-022-01104-6 |
| _version_ | 1811265140684750848 |
|---|---|
| author | Xue Dong Shuzong You Huangqi Zhang Dongnv Wang Wenting Pan Binhao Zhang Shanqiang Huang Xin Li Jianxin Pang Wenbin Ji |
| author_facet | Xue Dong Shuzong You Huangqi Zhang Dongnv Wang Wenting Pan Binhao Zhang Shanqiang Huang Xin Li Jianxin Pang Wenbin Ji |
| author_sort | Xue Dong |
| collection | DOAJ |
| description | Abstract Background Emphysematous pyelonephritis (EPN) is a potentially life-threatening disease caused by a gas-producing necrotizing bacterial infection that involves the renal parenchyma, collecting system, and/or perinephric tissue. EPN is often complicated by a previous diagnosis of diabetes mellitus, and venous air bubbles are an uncommon complication of it. We describe a 52-year-old woman who was admitted in coma, with a history of vomiting, and was found to have EPN with air bubbles in the uterine veins. We discuss the presentation, diagnosis, and pathogenesis of this uncommon but clinically significant event, and briefly review other case reports of venous gas or thrombosis caused by EPN. Case presentation We report the case of a 52-year-old woman with past history of type 2 diabetes mellitus, presenting with loss of consciousness after vomiting for half a day. Abdominal computed tomography scan revealed unilateral EPN with air bubbles in the uterine veins. The blood, pus, and urine cultures were positive for extended-spectrum beta-lactamase-producing Escherichia coli. The patient’s condition improved well after conservative management comprising supportive measures, broad-spectrum antibiotics, percutaneous drainage therapy, and an open operation. Conclusions Venous air bubbles are rare but fatal complication of EPN. Early diagnosis and treatment are critical to ensure good results. |
| first_indexed | 2024-04-12T20:17:27Z |
| format | Article |
| id | doaj.art-99b7fedf948247789572895fbba4a736 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-12T20:17:27Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-99b7fedf948247789572895fbba4a7362022-12-22T03:18:05ZengBMCBMC Urology1471-24902022-09-012211710.1186/s12894-022-01104-6Venous gas caused by emphysematous pyelonephritis: a case report and review of literatureXue Dong0Shuzong You1Huangqi Zhang2Dongnv Wang3Wenting Pan4Binhao Zhang5Shanqiang Huang6Xin Li7Jianxin Pang8Wenbin Ji9Department of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityDepartment of Radiology, Taizhou Hospital, Zhejiang UniversityAbstract Background Emphysematous pyelonephritis (EPN) is a potentially life-threatening disease caused by a gas-producing necrotizing bacterial infection that involves the renal parenchyma, collecting system, and/or perinephric tissue. EPN is often complicated by a previous diagnosis of diabetes mellitus, and venous air bubbles are an uncommon complication of it. We describe a 52-year-old woman who was admitted in coma, with a history of vomiting, and was found to have EPN with air bubbles in the uterine veins. We discuss the presentation, diagnosis, and pathogenesis of this uncommon but clinically significant event, and briefly review other case reports of venous gas or thrombosis caused by EPN. Case presentation We report the case of a 52-year-old woman with past history of type 2 diabetes mellitus, presenting with loss of consciousness after vomiting for half a day. Abdominal computed tomography scan revealed unilateral EPN with air bubbles in the uterine veins. The blood, pus, and urine cultures were positive for extended-spectrum beta-lactamase-producing Escherichia coli. The patient’s condition improved well after conservative management comprising supportive measures, broad-spectrum antibiotics, percutaneous drainage therapy, and an open operation. Conclusions Venous air bubbles are rare but fatal complication of EPN. Early diagnosis and treatment are critical to ensure good results.https://doi.org/10.1186/s12894-022-01104-6Emphysematous pyelonephritisVenous gasEscherichia coliTreatmentPathogenesis |
| spellingShingle | Xue Dong Shuzong You Huangqi Zhang Dongnv Wang Wenting Pan Binhao Zhang Shanqiang Huang Xin Li Jianxin Pang Wenbin Ji Venous gas caused by emphysematous pyelonephritis: a case report and review of literature BMC Urology Emphysematous pyelonephritis Venous gas Escherichia coli Treatment Pathogenesis |
| title | Venous gas caused by emphysematous pyelonephritis: a case report and review of literature |
| title_full | Venous gas caused by emphysematous pyelonephritis: a case report and review of literature |
| title_fullStr | Venous gas caused by emphysematous pyelonephritis: a case report and review of literature |
| title_full_unstemmed | Venous gas caused by emphysematous pyelonephritis: a case report and review of literature |
| title_short | Venous gas caused by emphysematous pyelonephritis: a case report and review of literature |
| title_sort | venous gas caused by emphysematous pyelonephritis a case report and review of literature |
| topic | Emphysematous pyelonephritis Venous gas Escherichia coli Treatment Pathogenesis |
| url | https://doi.org/10.1186/s12894-022-01104-6 |
| work_keys_str_mv | AT xuedong venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT shuzongyou venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT huangqizhang venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT dongnvwang venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT wentingpan venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT binhaozhang venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT shanqianghuang venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT xinli venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT jianxinpang venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature AT wenbinji venousgascausedbyemphysematouspyelonephritisacasereportandreviewofliterature |