Emphysematous pyelonephritis and septic shock in an elderly male patient caused by extended-spectrum beta-lactamase producing Klebsiella pneumoniae

Abdulmalik Altayib; Badr Badr; Abdullah Basnawi; Abdalla Khalil; Saleh Binsalman

doi:10.1016/j.eucr.2020.101353

Emphysematous pyelonephritis and septic shock in an elderly male patient caused by extended-spectrum beta-lactamase producing Klebsiella pneumoniae

Urol Case Rep. 2020 Jul 18:33:101353. doi: 10.1016/j.eucr.2020.101353. eCollection 2020 Nov.

Authors

Abdulmalik Altayib¹, Badr Badr², Abdullah Basnawi³, Abdalla Khalil⁴, Saleh Binsalman⁵

Affiliations

¹ Section Head of Urology Department, IMC Hospital Jeddah, 2172, Saudi Arabia.
² Medical Imaging Department, IMC Hospital Jeddah, 2172, Saudi Arabia.
³ Emergency Medicine, IMC Hospital Jeddah, 2172, Saudi Arabia.
⁴ Internal Medicine, Emergency Department, Jeddah, 2172, Saudi Arabia.
⁵ Senior Specialist, Urology Department, IMC Hospital Jeddah, 2172, Saudi Arabia.

Abstract

Emphysematous Pyelonephritis is a rare necrotizing infection with gas production and a high overall mortality rate. An elderly diabetic male patient presented to our Emergency Department with septic shock and was found to have left perinephric emphysematous pyelonephritis with a large collection. He was managed with the proper antibiotic therapy, and two trials of percutaneous drainage of the collection with no significant reduction in the size of the abscess. After operative drainage and debridement of multiple pockets, he improved and was discharged home. Extender spectrum beta-lactamase producing organism was an additional challenge in our patient's management.

Keywords: Emphysematous pyelonephritis; Extended spectrum beta-lactamase producing organisms; Percutaneous drainage; Surgical operative drainage..

Publication types

Case Reports