scholarly journals Emphysematous pyelonephritis in an infant from Sokoto, north-western Nigeria

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatima B. Jiya ◽  
Paul K. Ibitoye ◽  
Nma M. Jiya ◽  
Maryam Amodu-Sanni ◽  
Yahaya Mohammed ◽  
...  
Keyword(s):  
Abdominal Mass ◽  
Male Infant ◽  
University Teaching ◽  
Emphysematous Pyelonephritis ◽  
Left Flank ◽  
Paediatric Unit ◽  
Life Threatening ◽  
History Of ◽  
Excessive Crying ◽  
North Western

Introduction: Emphysematous pyelonephritis is a life-threatening necrotising bacterial infection of the kidneys. It is rare among children and can be fatal if not promptly identified and treated.Case presentation: A 7-month-old male infant presented to the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, on 12 November 2019 with a 5-day history of fever and vomiting, and a 3-day history of a progressively enlarging, left-side abdominal mass. There was associated excessive crying on micturition, refusal to feed and weight loss. He looked ill and was in respiratory distress, irritable, febrile (38.8 °C), moderately dehydrated and pale. His weight and length were 5.5 kg and 64 cm. He had a tender, firm and ballotable abdominal mass on the left flank measuring 8 cm × 10 cm. His pulse rate was 140 beats/min, blood pressure 60/40 millimetres of mercury and respiratory rate was 65 cycles/min. He had widespread coarse crepitations and normal heart sounds on chest auscultation.Management and outcome: An initial diagnosis of sepsis was made. Other considerations were nephroblastoma and neuroblastoma. Ceftriaxone and blood transfusion were commenced with subsequent administration of intravenous fluids. Further radiologic investigations revealed emphysematous pyelonephritis. The patient had percutaneous drainage and extended spectrum β-lactamase-producing Escherichia coli (sensitive to meropenem) which was isolated from the aspirate culture after 48 h of incubation. Meropenem could not be commenced because of non-availability and high cost. The patient subsequently deteriorated and died from septic shock.Conclusion: Emphysematous pyelonephritis has a fulminant course when not diagnosed promptly and treated adequately.

scholarly journals Different Imaging Modalities for Evaluating Emphysematous Pyelonephritis (EPN); a Life Threatening Urological Emergency – A case report

2018 ◽  
Vol 20 (1) ◽  
pp. 63
Author(s):  
Rawnak Afrin ◽  
ABM Golam Mostofa ◽  
Shankar Kumar Biswas ◽  
Sadia Hossain ◽  
Sanowar Hossain
Keyword(s):  
Left Kidney ◽  
Lower Abdominal Pain ◽  
Tertiary Hospital ◽  
Renal Parenchyma ◽  
Ct Number ◽  
Emphysematous Pyelonephritis ◽  
Left Flank ◽  
Life Threatening ◽  
Urological Emergency ◽  
Contrast Ct

<p>Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the renal parenchyma; it causes gas formation within the collecting system, renal parenchyma, and/or perirenal tissues. In this reported case, a female patient of 40 years was admitted in a tertiary hospital with history of severe left flank pain, lower abdominal pain, fever, vomiting and scanty micturition for three days. Ultrasonogram showed-normal right kidney but left renal bed reveals extensive air obscuring visualization of left kidney with probe tenderness in left flank. Contrast CT scan of KUB shows larger left kidney with extensive air (CT number = -1000 HU) within the renal parenchyma, collecting systems and perinephric space. This case was diagnosed as EPN. After conservative treatment patient was improved significantly.</p><p>Bangladesh J. Nuclear Med. 20(1): 63-66, January 2017</p>

scholarly journals Emphysematous pyelonephritis with Dengue hemorrhagic fever: A successful medical management of a fatal scenario

2017 ◽  
Vol 8 (5) ◽  
pp. 101-103
Author(s):  
Robin George Manappallil ◽  
Prathap Reddy Muthyala
Keyword(s):  
Dengue Fever ◽  
Hemorrhagic Fever ◽  
Severe Form ◽  
Medical Sciences ◽  
Emphysematous Pyelonephritis ◽  
Associated Gas ◽  
Acute Necrotizing ◽  
Life Threatening ◽  
History Of ◽  
Plasma Leakage

Emphysematous pyelonephritis is a life threatening acute necrotizing infection with associated gas formation involving the renal parenchyma and perinephric tissues. Dengue fever, according to the WHO, is the most rapidly spreading mosquito borne viral infection in the world. Dengue Hemorrgahic Fever is a more severe form of dengue fever and is characterized by fever, bleeding manifestations, plasma leakage and thrombocytopenia. This is a case of a 56 year old female, who presented with history of fever, headache, myalgia and dysuria; and was diagnosed to have emphysematous pyelonephritis with Dengue Hemorrgahic Fever. She was successfully managed with intravenous antibiotics and platelet transfusions, without any urological interventions. Asian Journal of Medical Sciences Vol.8(5) 2017 101-103

scholarly journals Emphysematous pyelonephritis with complete duplication of the left urinary tract

2013 ◽  
Vol 5 (6) ◽  
pp. 101
Author(s):  
Yasuto Yamasaki ◽  
Shigehiko Koga ◽  
Yuzo Minami ◽  
Hideki Sakai
Keyword(s):  
Urinary Tract ◽  
Japanese Literature ◽  
Flank Pain ◽  
High Grade ◽  
High Grade Fever ◽  
Emphysematous Pyelonephritis ◽  
Left Flank ◽  
Life Threatening ◽  
Complete Duplication ◽  
Left Flank Pain

Emphysematous pyelonephritis (EPN) is a life-threatening bacterialinfection and should be treated rapidly and carefully. We reporta case of EPN with complete duplication of the left urinary tract.A 68-year-old woman was admitted to our hospital complainingof high-grade fever and left flank pain. An abdominal computedtomography scan showed gas was presented in the renal parenchyma,not only the pelvis and ureter. Based on these findings,a diagnosis of left EPN was made. A partial nephrectomy of theaffected left upper pole moiety was performed and the patientunderwent additional medical management. Other 83 cases ofEPN from the Japanese literature were reviewed.

scholarly journals Emphysematous pyelonephritis: is conservative management effective? Our experience and review of literature

2020 ◽  
Vol 7 (3) ◽  
pp. 849
Author(s):  
Atul Kumar Khandelwal
Keyword(s):  
Percutaneous Drainage ◽  
Early Stage ◽  
Abdominal Mass ◽  
Review Of Literature ◽  
Emphysematous Pyelonephritis ◽  
Life Threatening ◽  
Laboratory Investigations ◽  
Time Of Presentation ◽  
Time Of Admission

Background: Emphysematous pyelonephritis (EPN) is a urologic emergency caused by a life-threatening necrotizing infection of the kidney leading to an accumulation of gas in the renal parenchyma and perirenal tissue. we present the clinical details and outcome of twelve patients of managed at our institute and discuss their management and outcomes.Methods: Twelve consecutive patients with EPN were managed in our institute from July 2014 to July 2018. Data on demographic profile, clinical features, laboratory investigations, imaging studies, outcome of patients and follow up details were recorded.Results: Out of 12 patients with EPN, nine were female and three were male. Ten patients were diabetic (83%). All the diabetic patient had raised blood sugar at the time of admission ureteric stone was present in two nondiabetic patients. All the patients had fever at the time of presentation while localized flank pain was present in 6 (50%) patients. On examination, renal angle tenderness was present in ten patients while abdominal mass found in three patients. Pyuria was found in all patients while leukocytosis found in 10 patients. Two patients had thrombocytopenia while 4 had deranged renal parameters at the time of admission. Urine culture showed Escherichia coli in 8 patients and Klebsiella in two patients. Four patients required percutaneous drainage. Interval nephrectomy was done in one patient due to non-functioning kidney.Conclusions: Majority of patients diagnosed as emphysematous pyelonephritis were managed conservatively due to diagnosed at an early stage. Percutaneous drainage is successfully utilized in patients with more advanced disease.

scholarly journals Wandering airway foreign body in early infancy

2020 ◽  
Vol 7 (8) ◽  
pp. 1798
Author(s):  
Rajkumar M. Meshram ◽  
Nilesh Nagdive ◽  
Vishal S. Gajimwar ◽  
Parameshappa N. Nandikoppa ◽  
Suraj P. Gondase
Keyword(s):  
Foreign Body ◽  
Male Infant ◽  
Tracheobronchial Tree ◽  
Respiratory Passage ◽  
Impacted Foreign Body ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Appropriate Therapy ◽  
High Index Of Suspicion

Accidental impaction of objects in the respiratory passage is a life-threatening condition. A 9-month-old male infant was admitted with fever, cough and respiratory distress without history of choking. He was treated as wheezy bronchitis with appropriate therapy but, did not show response. HRCT showed an impacted foreign body in the trachea which caused a partial luminal compromise. Two attempts to remove foreign body by rigid bronchoscope failed, and tracheostomy was performed due to fall in oxygen saturation. After stabilization, again saturation was falling and air entry was absent on right hemithorax. Considering the possibility of movement of foreign body in right bronchus, bronchoscope was reintroduced and foreign body was removed in piecemeal. This process was complicated with cardiorespiratory arrest, twice from which the patient was revived. Postoperative period was uneventful. So, high index of suspicion is required to diagnose such a foreign body of the tracheobronchial tree to prevent morbidity and mortality.      

scholarly journals Giant Extraluminal Leiomyoma of the Colon: Rare Cause of Symptomatic Pelvic Mass

2015 ◽  
Vol 100 (5) ◽  
pp. 805-808 ◽  
Author(s):  
Andrea Sagnotta ◽  
Alessandra Sparagna ◽  
Stefania Uccini ◽  
Paolo Mercantini
Keyword(s):  
Small Intestine ◽  
Sigmoid Colon ◽  
Abdominal Mass ◽  
Pelvic Mass ◽  
Abdominal Distension ◽  
Colon Resection ◽  
Life Threatening ◽  
History Of ◽  
Palpable Abdominal Mass

Leiomyomas (LMs) may appear throughout the entire gastrointestinal tract but are rarely seen in the colon-rectum and only 5 of those measured greater than 15 cm in diameter. Pain and palpable abdominal mass are the most common symptoms. Surgical resection is the treatment of choice for most LMs. We here describe a case of a 46-year-old woman who presented with a 3-month history of abdominal pain associated with worsening constipation and abdominal distension. A pelvic solid, polylobulate, left-sided mass was noted on examination. Preoperative findings revealed a dishomogeneous sigmoid mass with calcified spots compressing small intestine and bladder. At laparotomy, a large polylobulate and well-circumscribed mass arising from the descending colon mesentery and displacing small intestine, uterus, and ovaries. A segmental colon resection was performed. An extraluminal 18- × 12- × 5-cm paucicellular sigmoid colon leiomyoma was histologically diagnosed. Our case is one of the few giant (&gt;15 cm) sigmoid colon LMs reported in the literature. Although rare and benign in nature, LMs of the colon can cause life-threatening complications that could require emergency treatment and they should be included in the differential diagnosis of large abdominopelvic masses. Follow-up after surgery is necessary for tumors with any atypia or mitotic activity.

scholarly journals Profile of Anaemia in HIV Positive Patients

2016 ◽  
Vol 12 (2) ◽  
pp. 70-73 ◽  
Author(s):  
Khem Raj Bhusal ◽  
Surya Devkota ◽  
Midhan Shrestha ◽  
Prem Khadga
Keyword(s):  
University Teaching ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
Mild Anemia ◽  
High Prevalence ◽  
Moderate Anemia ◽  
Life Threatening ◽  
History Of ◽  
Prevalence Of Anemia

Background & Objectives: This was a cross-sectional observational study designed to see the prevalence of anemia among HIV positive patients and its correlation with CD4 counts.Materials & Methods: Fifty five HIV/AIDS patients presented for the first time to Tribhuwan University Teaching Hospital [TUTH] were enrolled in the study. Patients' duration of HIV positivity, history regarding ART and duration, history of associated co morbid or opportunistic conditions were taken, CD4 counts, RFT, CBC test results were recorded. Patients' clinical and laboratory parameters were recorded. Anaemia was classified by WHO criteria for both men and women.Results: Out of 55 patients, 23 (42 %) had anemia, out of which 14 (60.87 %) had mild anemia (anemia but Hb not less than 9.5g/dl), four (17.39%) had moderate anemia (Hb 8 to 9.4 g/ dL) and two (8.7%) had severe anemia (Hb 6.5 to 7.9 g/dL) and three (13.04%) had very severe or life threatening anemia (Hb less than 6.5 g/dL). Corresponding odds ratio from stage CD4 counts<200 to CD4 counts >/= 200 for anemia was 4.55 times; which is statistically significant (p<0.0001). There was negative association between the prevalence of anemia and HIV stage (CD4 count).Conclusion: There was high prevalence of anemia and severity of immunodeficiency directly correlates with degree of anemia. Degree of anemia can be easily assessed even in rural clinical setting, hence degree of immunodeficiency can early be detected in all settings.JCMS Nepal. 2016;12(2):70-3

scholarly journals Emphysematous pyelonephritis: a rare case report

2017 ◽  
Vol 4 (2) ◽  
pp. 596
Author(s):  
Shubhransu Patro ◽  
Pankaj Kumar Khora ◽  
Sukanta Kumar Padhy
Keyword(s):  
Diabetes Mellitus ◽  
Rare Case ◽  
Flank Pain ◽  
Emphysematous Pyelonephritis ◽  
Patients With Diabetes ◽  
Rare Case Report ◽  
Life Threatening ◽  
History Of ◽  
Aggressive Medical Management ◽  
Previous Medical History

Emphysematous pyelonephritis (EPN) is a rare and life threatening infection of kidney characterized by gas in the renal parenchyma and surrounding tissues. It occurs mostly in patients with diabetes mellitus and has a predilection for females. It is associated with a high mortality in the absence of rapid and effective treatment; therefore, aggressive medical management, early intervention or surgical approach is recommended. Reported here is a case of a 52-year female with previous medical history of diabetes presented with uncontrolled hyperglycaemia, fever and dysuria with right sided flank pain. She was diagnosed with emphysematous pyelonephritis and successfully treated. As emphysematous pyelonephritis is a life-threatening infection, it should always be considered in the differential diagnosis for a patient with fever with abdominal pain or suspected pyelonephritis particularly in a diabetic.

Distribution, systematics and nomenclature of the three taxa of Common Stonechats (Aves, Passeriformes, Muscicapidae, Saxicola) that breed in the Caucasian region

2020 ◽  
Vol 29 (1) ◽  
pp. 33-57
Author(s):  
V.M. Loskot ◽  
G.B. Bakhtadze
Keyword(s):  
Geographic Distribution ◽  
Habitat Preferences ◽  
Junior Synonym ◽  
Type Locality ◽  
Diagnostic Features ◽  
Western Turkey ◽  
Geographical Variations ◽  
History Of ◽  
The Individual ◽  
North Western

Geographic distribution and habitat preferences of Saxicola rubicola rubicola (Linnaeus, 1766), S. maurus variegatus (S.G. Gmelin, 1774), and S. m. armenicus (Stegman, 1935) inhabiting the Caucasian Isthmus and adjacent areas are described in detail. We examined the individual, sexual, age, seasonal and geographical variations of seven main diagnostic features of both plumage and morphometrics (exactly, the length of wing and tail) using 381 skin specimens. Substantially improved diagnoses of S. m. variegatus and S. m. armenicus are provided. After a thorough examination of the materials and history of the expedition of Samuel Gmelin in 1768–1774, and his description of Parus variegatus, it was concluded that the type locality of this taxon was the vicinity of Shamakhi in Azerbaijan not Enzeli in North-Western Turkey. It is also shown the fallacy of the recently proposed attribution of the holotype of the northern subspecies S. m. variegatus to the southern taxon S. m. armenicus and synonymisation of these names, as well as the replacement of the name S. m. variegatus by its junior synonym S. m. hemrichii Ehrenberg, 1833 for the northern subspecies.

scholarly journals Catheter Ablation of Life-Threatening Ventricular Arrhythmias in Athletes

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 205
Author(s):  
Nicola Tarantino ◽  
Domenico G. Della Rocca ◽  
Nicole S. De Leon De La Cruz ◽  
Eric D. Manheimer ◽  
Michele Magnocavallo ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Individual Factors ◽  
Substantial Part ◽  
Arrhythmogenic Substrate ◽  
Life Threatening ◽  
History Of ◽  
Anatomic Distribution ◽  
Artery Disease ◽  
Surveillance Analysis

A recent surveillance analysis indicates that cardiac arrest/death occurs in ≈1:50,000 professional or semi-professional athletes, and the most common cause is attributable to life-threatening ventricular arrhythmias (VAs). It is critically important to diagnose any inherited/acquired cardiac disease, including coronary artery disease, since it frequently represents the arrhythmogenic substrate in a substantial part of the athletes presenting with major VAs. New insights indicate that athletes develop a specific electro-anatomical remodeling, with peculiar anatomic distribution and VAs patterns. However, because of the scarcity of clinical data concerning the natural history of VAs in sports performers, there are no dedicated recommendations for VA ablation. The treatment remains at the mercy of several individual factors, including the type of VA, the athlete’s age, and the operator’s expertise. With the present review, we aimed to illustrate the prevalence, electrocardiographic (ECG) features, and imaging correlations of the most common VAs in athletes, focusing on etiology, outcomes, and sports eligibility after catheter ablation.

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