Cases reported "Diabetic Nephropathies"

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1/36. Bilateral emphysematous pyelonephritis caused by Candida infection.

    Emphysematous pyelonephritis is a rare, often severe infection of one or both kidneys that is most often caused by bacterial infection. Surgical intervention is often necessary. We describe a case of a diabetic patient with bilateral emphysematous pyelonephritis caused by Candida infection that was treated conservatively. Renal function recovered almost completely in spite of giving a potential nephrotoxic drug for 6 weeks.
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keywords = pyelonephritis
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2/36. Emphysematous pyelonephritis: case report and review of the literature.

    Emphysematous pyelonephritis (EP), a rare necrotizing infection of the upper urinary tract, is a life-threatening complication of patients with diabetes mellitus. A case of EP is described where the diagnosis was delayed for 36 h and the patient died notwithstanding aggressive medical and surgical intervention. The demonstration of gas in the renal structures is pathognomonic of EP. Because early diagnosis and aggressive medical and surgical management is imperative for recovery, we recommend plain abdominal radiographs as a minimal screening tool for all diabetic patients who present to hospital with a presumptive pyelonephritis. The diagnosis should also be considered in patients who failed appropriate medical therapy.
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ranking = 1.0000693768334
keywords = pyelonephritis, necrotizing
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3/36. Fatal emphysematous pyelonephritis with gas in the spinal extradural space in a patient with diabetes.

    BACKGROUND: Emphysematous pyelonephritis (EP) is a rare but life-threatening condition of the upper urinary tract, characterized by the presence of gas in the renal parenchyma and perirenal space. The vast majority of patients with EP (90%) are known to have diabetes, with escherichia coli being the most common causative pathogen. CASE REPORT: We present a case of fatal bilateral EP in a patient with diabetes, with an unusual radiological finding of gas around the spinal cord and in the psoas muscle, with renal parenchymal sparing. Our case serves as an important reminder of this life threatening entity in diabetic patients, which is not well recognized by clinicians because of its rarity.
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ranking = 0.83333333333333
keywords = pyelonephritis
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4/36. Candida fasciitis following renal transplantation.

    BACKGROUND: We describe a rare case of necrotizing fasciitis involving candida albicans, an organism that has been reported to have a minimal potential for invasive soft tissue infection. In this case, immunosuppression, chronic renal failure, and a history of diabetes mellitus were predisposing factors. methods: The medical record and histopathologic material were examined. The clinical literature was reviewed for previous cases of C albicans necrotizing fasciitis. RESULTS: A review of the literature showed that in solid organ transplant recipients, localized fungal soft tissue infection is infrequent, with only 35 cases reported between 1974 and 1992. Necrotizing fasciitis caused by C albicans is extremely rare in the modern era of solid organ transplantation. CONCLUSIONS: The management of transplant patients at risk for invasive fungal infection warrants a high index of suspicion for fungal necrotizing fasciitis in the setting of wound infection and merits a thorough investigation for atypical pathogens.
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ranking = 0.00020813050022867
keywords = necrotizing
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5/36. Myeloperoxidase-antineutrophil cytoplasmic antibody-associated glomerulonephritis superimposed on biopsy-proven diabetic nephrosclerosis.

    We present a case of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-associated glomerulonephritis with diabetic nephrosclerosis, diagnosed by serial renal biopsies within a short period. A 78-year-old man with renal insufficiency, who had been diagnosed with diabetic nephrosclerosis by renal biopsy 9 months earlier, was admitted to the hospital for dyspnea and rapid deterioration of renal function. The titer of serum MPO-ANCA was high, and the second renal biopsy confirmed the presence of necrotizing glomerulonephritis with crescents. methylprednisolone pulse therapy followed by oral administration of prednisolone led to resolution of respiratory symptoms and reversal of MPO-ANCA. Renal function did not improve, however, necessitating hemodialysis. A review of the literature showed several cases of necrotizing glomerulonephritis superimposed on diabetic nephropathy but only a few reported cases of MPO-ANCA glomerulonephritis associated with diabetic nephrosclerosis. Diabetic patients who show rapid deterioration of renal function should undergo renal biopsy to determine the concomitant presence, if any, of other glomerular diseases and to prevent life-threatening systemic involvement.
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ranking = 0.00013875366681912
keywords = necrotizing
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6/36. Successful treatment of necrotizing fasciitis associated with diabetic nephropathy.

    A 50-year-old woman with a 15-year history of type 2 diabetes mellitus was admitted to our hospital due to high fever and a skin lesion with severe pain, swelling and a sensation of heat in the right thigh. Laboratory examination showed elevated c-reactive protein (CRP), thrombocytopenia, nephrotic syndrome and renal dysfunction. Her blood glucose level had been well controlled. streptococcus agalactiae was detected in both the skin lesion and blood culture, and pathological examination revealed neutrophil infiltration in the fascia and muscle layer. The patient was diagnosed with necrotizing fasciitis, septic shock and disseminated intravascular coagulation. A combination therapy of antibiotics and surgical debridement resulted in the improvement of symptoms as supported by laboratory findings, and the skin lesion also showed improvement. Although group A streptococcus is well known to be implicated in the pathogenesis of necrotizing fasciitis, only S. agalactiae, belonging to group B streptococcus, was isolated from the tissue and blood cultures in this case. Although this organism is not virulent and rarely causes a necrotizing fasciitis, both the superficial fascial layer and underlying muscle were affected in this case. There have been only a few reports of necrotizing fasciitis due to S. agalactiae in patients with diabetes mellitus. Although the blood glucose level was well controlled in our patient, this disease might be caused by other factors, including diminished sense of touch and pain, abnormality of microcirculation and hypogammaglobulinemia due to nephrotic syndrome.
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ranking = 0.00055501466727646
keywords = necrotizing
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7/36. Laparoscopic nephrectomy for emphysematous pyelonephritis.

    Emphysematous pyelonephritis is a serious suppurative infection of the renal and extrarenal tissues. Controversies exist surrounding the appropriate management of this life-threatening condition with advocates for both medical management alone and percutaneous drainage combined with nephrectomy. The laparoscopic approach for nephrectomy is quickly becoming the standard of care for benign disease of the kidney and low-stage renal cancers. We report a case of a 60-year-old diabetic male undergoing successful laparoscopic nephrectomy for right emphysematous pyelonephritis, and our procedural technique. To our knowledge, this is the first report of laparoscopic nephrectomy in the setting of emphysematous pyelonephritis. Carefully selected patients with emphysematous pyelonephritis may benefit from the advantages of laparoscopic nephrectomy in centers with sufficient laparoscopic experience.
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ranking = 1.3333333333333
keywords = pyelonephritis
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8/36. Emphysematous pyelonephritis: a case report and review of the literature.

    We present a case of fulminant emphysematous pyelonephritis in a 44-year-old diabetic woman culminating in emergent nephrectomy. Current management strategies and their outcomes are reviewed.
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ranking = 0.83333333333333
keywords = pyelonephritis
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9/36. Emphysematous pyelonephritis. Complicated urinary tract infection in diabetes.

    Renal emphysema is rare condition that may affect diabetic patients. Radiographic demonstration of gas limited to the collecting system is often treated with antibiotics. However, intraparenchymal gas requires early nephrectomy because mortality rates are high without surgical intervention.
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ranking = 0.66666666666667
keywords = pyelonephritis
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10/36. Reversible acute renal failure due to churg-strauss syndrome.

    Renal disease in churg-strauss syndrome is generally thought to be benign in nature, thereby distinguishing this rare condition from other necrotizing vasculitides. We report a case in which acute renal failure developed during the aggressive vasculitic phase of the illness requiring dialysis therapy. After one week of daily haemodialysis treatment the patient had become encephalopathic associated with marked peripheral eosinophilia. Treatment with prednisolone resulted in a marked improvement in both clinical condition and renal function.
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ranking = 6.9376833409558E-5
keywords = necrotizing
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