Emphysematous pyelonephritis caused by Raoultella ornithinolytica: a case report.


Journal

BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793

Informations de publication

Date de publication:
27 Oct 2024
Historique:
received: 18 01 2024
accepted: 04 10 2024
medline: 28 10 2024
pubmed: 28 10 2024
entrez: 28 10 2024
Statut: epublish

Résumé

Emphysematous pyelonephritis is a rare and severe urinary tract infection that is potentially life-threatening and easily progresses to septic shock. In this report, we present a unique case of emphysematous pyelonephritis caused by Raoultella ornithinolytica. An 86-year-old man presented with severe back pain of 3 days' duration. He had a history of hypertension and diabetes for more than 20 years, and his infection indicators and serum creatinine were elevated. Abdominal computed tomography revealed an abnormal gas shadow around his right kidney and the anterior edge of his right psoas muscle. Consequently, he was initially diagnosed with emphysematous pyelonephritis. There was no evidence of nephrolithiasis or other anatomical or structural abnormalities that could have precipitated this focal renal infection. Both blood and drainage fluid cultures revealed R. ornithinolytica. After early anti-infection treatment, percutaneous drainage and moderate control of blood glucose, the patient gradually recovered. Emphysematous pyelonephritis caused by R. ornithinolytica is rare but has a high drug resistance rate potentially and may cause severe infections. Early diagnosis, prompt use of antibiotics that are sensitive to the organism, and decompression drainage could be the key to treatment.

Sections du résumé

BACKGROUND BACKGROUND
Emphysematous pyelonephritis is a rare and severe urinary tract infection that is potentially life-threatening and easily progresses to septic shock. In this report, we present a unique case of emphysematous pyelonephritis caused by Raoultella ornithinolytica.
CASE PRESENTATION METHODS
An 86-year-old man presented with severe back pain of 3 days' duration. He had a history of hypertension and diabetes for more than 20 years, and his infection indicators and serum creatinine were elevated. Abdominal computed tomography revealed an abnormal gas shadow around his right kidney and the anterior edge of his right psoas muscle. Consequently, he was initially diagnosed with emphysematous pyelonephritis. There was no evidence of nephrolithiasis or other anatomical or structural abnormalities that could have precipitated this focal renal infection. Both blood and drainage fluid cultures revealed R. ornithinolytica. After early anti-infection treatment, percutaneous drainage and moderate control of blood glucose, the patient gradually recovered.
CONCLUSIONS CONCLUSIONS
Emphysematous pyelonephritis caused by R. ornithinolytica is rare but has a high drug resistance rate potentially and may cause severe infections. Early diagnosis, prompt use of antibiotics that are sensitive to the organism, and decompression drainage could be the key to treatment.

Identifiants

pubmed: 39465368
doi: 10.1186/s12882-024-03791-9
pii: 10.1186/s12882-024-03791-9
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

382

Informations de copyright

© 2024. The Author(s).

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Auteurs

Meng Sun (M)

Department of Nephrology, Lianyungang Clinical College of Nanjing Medical University, The First People's Hospital of Lianyungang, 6 Zhenhua East Road, Lianyungang, 222002, China.

Xiaobao Wei (X)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Xinyu Xiang (X)

Department of Nephrology, Lianyungang Clinical College of Nanjing Medical University, The First People's Hospital of Lianyungang, 6 Zhenhua East Road, Lianyungang, 222002, China.

Ting Zhang (T)

Department of Nephrology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Yiwen Zhang (Y)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Jiayi Miao (J)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Juanyu Wei (J)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Wei Cao (W)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Qing Yao (Q)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Ling Zhu (L)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Ying Zhou (Y)

Department of Nephrology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.

Liyuan Zhang (L)

Department of Nephrology, Lianyungang Clinical College of Nanjing Medical University, The First People's Hospital of Lianyungang, 6 Zhenhua East Road, Lianyungang, 222002, China. zlylygyy@163.com.

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