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Emphysematous Pyelonephritis—an Unexpected Cause of Extensive Subcutaneous Emphysema: Case Report

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Abstract

Emphysematous pyelonephritis (EPN) can be lethal and organ threatening if not recognized and treated promptly. We report a case of EPN presenting with extensive subcutaneous emphysema. A 42-year-old patient presented with severe sepsis and impending diabetic ketoacidosis. Investigations showed ruptured right EPN which resulted in pneumo-retroperitoneum, pneumo-mediastinum, and extensive subcutaneous emphysema. Emergency open retroperitoneal surgical drainage in addition to targeted antibiotics was started. Patient recovered well clinically and radiologically without a need for nephrectomy. Prompt diagnosis and timely treatment are of utmost importance. Clinical suspicion should be heightened in at-risk patients who present in sepsis state with a diagnosis of pyelonephritis or those who are not responding to the routine management of pyelonephritis.

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Authors and Affiliations

  1. Department of Internal Medicine, Miri General Hospital, Jalan Cahaya, 98000, Miri, Sarawak, Malaysia

    Andy Sing Ong Tang, Hock Jie Gan & Ingrid Pao Lin Ting

  2. Department of Pharmacy, Miri General Hospital, Miri, Sarawak, Malaysia

    Siaw Tze Yeo

  3. Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Kuching, Sarawak, Malaysia

    Hock Hin Chua

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  1. Andy Sing Ong Tang
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  2. Hock Jie Gan
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  3. Ingrid Pao Lin Ting
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  4. Siaw Tze Yeo
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  5. Hock Hin Chua
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Correspondence to Andy Sing Ong Tang.

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This article does contain studies with human participant and was registered via National Medical Research Register Malaysia with a Research ID of 55572.

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Tang, A.S.O., Gan, H.J., Ting, I.P.L. et al. Emphysematous Pyelonephritis—an Unexpected Cause of Extensive Subcutaneous Emphysema: Case Report. SN Compr. Clin. Med. 3, 715–717 (2021). https://doi.org/10.1007/s42399-021-00805-7

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  • DOI: https://doi.org/10.1007/s42399-021-00805-7

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