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Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report

Fournier’s gangrene and emphysematous pyelonephritis are rare necrotizing infections of the genitourinary system. Many cases of this rapidly progressive infection occur from abscesses and urinary tract infections; however, Fournier’s gangrene secondary to emphysematous pyelonephritis is seldom discu...

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Autores principales: Fink, Benjamin A, Son, Young, Thomas, Brian, Mueller, Thomas J, Berkman, Douglas S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881273/
https://www.ncbi.nlm.nih.gov/pubmed/35233300
http://dx.doi.org/10.7759/cureus.21612
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author Fink, Benjamin A
Son, Young
Thomas, Brian
Mueller, Thomas J
Berkman, Douglas S
author_facet Fink, Benjamin A
Son, Young
Thomas, Brian
Mueller, Thomas J
Berkman, Douglas S
author_sort Fink, Benjamin A
collection PubMed
description Fournier’s gangrene and emphysematous pyelonephritis are rare necrotizing infections of the genitourinary system. Many cases of this rapidly progressive infection occur from abscesses and urinary tract infections; however, Fournier’s gangrene secondary to emphysematous pyelonephritis is seldom discussed in the literature. Emphysematous pyelonephritis is defined as a gas-forming, necrotizing infection of the renal parenchyma or its surrounding tissue. Emphysematous pyelonephritis has been observed in high-risk individuals, including those with poor glycemic control and urinary tract obstruction. We present a 61-year-old male with emphysematous pyelonephritis arising from a perinephric hematoma with tracking of the infection to the scrotum, resulting in Fournier’s gangrene. The perinephric hematoma most likely developed from increased intrarenal hydrostatic pressure during nephroureteral stent placement. Broad-spectrum antibiotic therapy and surgical debridement of the retroperitoneum, groin, and scrotum were performed ultimately requiring left orchiectomy. We conclude that an existing hematoma can precipitate emphysematous pyelonephritis with tracking from the retroperitoneum to scrotum, causing Fournier’s gangrene. High-risk patients with perinephric hematomas can be susceptible to this pathologic transformation.
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spelling pubmed-88812732022-02-28 Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report Fink, Benjamin A Son, Young Thomas, Brian Mueller, Thomas J Berkman, Douglas S Cureus Urology Fournier’s gangrene and emphysematous pyelonephritis are rare necrotizing infections of the genitourinary system. Many cases of this rapidly progressive infection occur from abscesses and urinary tract infections; however, Fournier’s gangrene secondary to emphysematous pyelonephritis is seldom discussed in the literature. Emphysematous pyelonephritis is defined as a gas-forming, necrotizing infection of the renal parenchyma or its surrounding tissue. Emphysematous pyelonephritis has been observed in high-risk individuals, including those with poor glycemic control and urinary tract obstruction. We present a 61-year-old male with emphysematous pyelonephritis arising from a perinephric hematoma with tracking of the infection to the scrotum, resulting in Fournier’s gangrene. The perinephric hematoma most likely developed from increased intrarenal hydrostatic pressure during nephroureteral stent placement. Broad-spectrum antibiotic therapy and surgical debridement of the retroperitoneum, groin, and scrotum were performed ultimately requiring left orchiectomy. We conclude that an existing hematoma can precipitate emphysematous pyelonephritis with tracking from the retroperitoneum to scrotum, causing Fournier’s gangrene. High-risk patients with perinephric hematomas can be susceptible to this pathologic transformation. Cureus 2022-01-25 /pmc/articles/PMC8881273/ /pubmed/35233300 http://dx.doi.org/10.7759/cureus.21612 Text en Copyright © 2022, Fink et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Urology
Fink, Benjamin A
Son, Young
Thomas, Brian
Mueller, Thomas J
Berkman, Douglas S
Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report
title Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report
title_full Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report
title_fullStr Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report
title_full_unstemmed Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report
title_short Emphysematous Pyelonephritis From a Perinephric Hematoma Complicated by Fournier’s Gangrene: A Case Report
title_sort emphysematous pyelonephritis from a perinephric hematoma complicated by fournier’s gangrene: a case report
topic Urology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881273/
https://www.ncbi.nlm.nih.gov/pubmed/35233300
http://dx.doi.org/10.7759/cureus.21612
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