CLINICO-MICROBIOLOGICAL SPECTRUM OF EMPHYSEMATOUS PYELONEPHRITIS: A TERTIARY CARE STUDY IN NORTH INDIA

Abstract

Emphysematous pyelonephritis (EPN) is a severe, gas-forming infection of the kidney involving the renal parenchyma, collecting system, or surrounding tissues. It occurs predominantly in patients with Diabetes Mellitus. Early aggressive medical treatment may help avoid surgical removal of the kidney (nephrectomy).Aim: To evaluate Clinical presentation, Diagnostic findings, Microbiological profile, treatment approaches. Patient outcomes and Prognostic factors influencing treatment success. Materials and Methods: Retrospective review of 40 patients with EPN was done. Analysis included: Clinical, laboratory, radiological, and microbiological data, treatment modalities and outcomes. Disease severity classified using the Huang classification system. Results: Diabetes Mellitus present in most patients. Majority were female (30 out of 40). Most common pathogen: Escherichia coli (30%). 24 patients (60%) improved with conservative management. 16 patients required ureteral stenting. No deaths reported with conservative treatment. About one-third had bilateral disease. Conclusions: EPN is strongly associated with diabetes and more common in women. Escherichia coli is the leading causative organism, Conservative treatment (antibiotics ± drainage) is effective in most cases. Nephrectomy should be reserved for: Patients who deteriorate Patients not responding to medical management.