Emphysematous pyelonephritis: Difference between revisions
(clinical features of emphysematous pyelonephritis) |
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==Workup== | ==Workup== | ||
===Labs=== | |||
*CBC with high WBC, low platelets | |||
*UA with urine culture | |||
*Creatinine | |||
*Blood culture | |||
===Imaging=== | |||
*CT is definitive | |||
==Management== | ==Management== | ||
Revision as of 16:25, 19 July 2015
Background
- Rare gas-forming infection nearly always occurring in pts w/ DM and obstruction
- Pts appear toxic and septic; nephrectomy may be required
Clinical Features
- fever
- abdominal or flank pain
- crepitus over the flank may be present in severe cases
- nausea/vomiting
- dyspnea
- acute kidney injury
- altered mental status
- shock
- thrombocytopenia
Differential Diagnosis
Dysuria
- Genitourinary infection
- Acute cystitis ("UTI")
- Pyelonephritis
- Urethritis
- Chronic cystitis
- Infected nephrolithiasis
- Prostatitis
- Epididymitis
- Renal abscess/perinephric abscess
- Emphysematous pyelonephritis
- Nephrolithiasis
- Urethral issue
- Urethritis
- Urolithiasis
- Urethral foreign body
- Urethral diverticulum
- Allergic reaction (contact dermatitis)
- Chemical irritation
- Urethral stricture or obstruction
- Trauma to vagina, urethra, or bladder
- Gynecologic
- Vaginitis/cervicitis
- PID
- Genital herpes
- Pelvic organ prolapse
- Fistula
- Cystocele
- Other
- Diverticulitis
- Interstitial cystitis
- Behavioral symptom without detectable pathology
Workup
Labs
- CBC with high WBC, low platelets
- UA with urine culture
- Creatinine
- Blood culture
Imaging
- CT is definitive