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12 Cards in this Set
- Front
- Back
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What is the emphysematous pyelonephritis
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Acute, fulminant, necrotizing infection of kidney and perirenal tissues associated with gas formation which may be life-threatening
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What are the organisms responsible for ephysematous pyelonephitis
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E. coli (vast majority of cases)
Klebsiella pneumoniae (9%) Proteus mirabilis Pseudomonas Enterobacter Candida |
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What are 3 predisposing factors to empysemaotous pyelonephritis
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Especially diabetics in almost all cases
Immunocompromised patients Ureteral obstruction |
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What are the CT findings in type 1 emphysematous pyelonephritis
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Streaky or mottled gas in interstitium of renal parenchyma radiating from medulla to cortex
Crescent of subcapsular or perinephric gas |
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What are the CT findings in type 2 emphysematous pyelonephritis
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Bubbly and/or loculated intrarenal gas (infers presence of abscess)
Renal and/or perirenal fluid collection Gas within collecting system in almost all |
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What is more common type 1 or 2 emphysematous pyelonephritis
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type2 in 66
% |
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What is a good way to differentiate type 1 from type 2 pyelonephritis
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presence of fluid collection
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Which type of emphysematous pyelonephritis has a worst prognosis
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type 1
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What can be found on ct with all types of emphysematous pyelonephritis
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Mottled areas of low attenuation extending radially along the pyramids
Extensive involvement of kidney and perinephric space Air extending through Gerota’s fascia into retroperitoneal space Occasionally gas in renal veins |
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What are the ultrasound findings of emphysematous pyelonephritis
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High-amplitude echoes within renal sinus and/or renal parenchyma associated with "dirty" shadowing
"Comet tail" reverberations Kidney may be completely obscured by large amount of gas in perinephric space (DDx: surrounding bowel gas) |
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What is the ddx to emphysematous pyelonephritis
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Emphysematous pyelitis (gas in collecting system but not in parenchyma, diabetes in 50%, less grave prognosis)
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What is a clue that there is likely a high rate of mortality in a patient with emphysematous pyelonephritis
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80% with extension into perirenal space
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