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Nephrol Dial Transplant (2001) 16: 1062-1065
© 2001 European Renal Association-European Dialysis and Transplant Association

Teaching Points

Unusual bacterial infections of the urinary tract in diabetic patients—rare but frequently lethal

(Section Editor: K. Kühn)

Ajay Kumar, John H. Turney, Aleck M. Brownjohn and Michael J McMahon1

Departments of Renal Medicine 1 Surgery, The General Infirmary, Leeds, UK

Keywords: urinary tract infections; diabetic patients; emphysematous pyelonephritis

Case 1

A 54-year-old, poorly compliant, insulin-requiring, diabetic man, who was also known to have a history of alcohol abuse, was referred to hospital with a 10-day history of progressive left-sided abdominal and loin pain, dysuria and fever. The onset of pneumaturia had prompted him to seek medical advice. Physical examination revealed an obese, dehydrated, ill-looking man with a temperature of 40°C. The blood pressure was 100/50 mmHg and pulse 105/min. He was markedly tender over the left side of the abdomen, and although bowel sounds were scanty there was no peritonism. Pertinent laboratory investigations showed a peripheral white cell count of 26x109/1, serum creatinine 185 µmol/l, urea 31 mmol/l and the glucose was 24 mmol/l. An IVU showed gas distending the left renal pelvis and ureter (Figure 1Go). Gas was also present in the renal parenchyma, extending into surrounding tissues, and was best seen on a CT . . . [Full Text of this Article]

Case 2

Case 3

Discussion

Teaching point

Notes

References


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