Hydropneumothorax as a complication of emphysematous pyelonephritis: case report

Abstract

Objective: Report a case of a diabetic patient with emphysematous pyelonephritis and a rare complication of hydropneumothorax. Case details: Female patient, 35 years old, white, with type 1 Diabetes Mellitus (DM1) sought medical attention with complain of diffuse abdominal pain associated with nausea and vomiting, fatigue, myalgia, asthenia, alterations of conscience level and poor glycemic control. Emphysematous pyelonephritis in the left kidney was confirmed by computed tomography, along with the identification of an ipsilateral hydropneumothorax. During hospitalization, appropriate clinical treatment was carried out in the Intensive Care Unit (ICU), as well as required surgical interventions (nephrectomy and chest drainage). Final considerations: Emphysematous pyelonephritis is an infectious disease of the upper urinary tract associated with gas formation and necrosis of the renal parenchyma. It is more frequent in adult women with diabetes and is considered a rare, complex condition with a severe course, often with surgical resolution. Related conditions such as renal failure and sepsis are not uncommon. The present study, however, describes a rare complication of hydropneumothorax, an infrequent association with the disease, little reported in the literature and of significant importance due to its severity and specific handling.