Emphysematous pyelonephritis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
* | *[[Fever]] | ||
* | *[[Abdominal pain]] or [[Flank pain]] | ||
**crepitus over the flank may be present in severe cases | **crepitus over the flank may be present in severe cases | ||
* | *[[Nausea/vomiting]] | ||
* | *[[Dyspnea]] | ||
* | *Renal dysfunction | ||
* | *[[Altered mental status]] | ||
* | *[[Shock]] | ||
* | *[[Thrombocytopenia]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 16:35, 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 pain or Flank pain
- crepitus over the flank may be present in severe cases
- Nausea/vomiting
- Dyspnea
- Renal dysfunction
- 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