Point-of-care ultrasound for the early diagnosis of emphysematous pyelonephritis: A case report and literature review

paythelady.612 shared this article with you from Inoreader Point-of-care ultrasound for the early diagnosis of emphysematous pyelonephritis: A case report and literature review Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 16;9(11):2584-2594. doi: 10.12998/wjcc.v9.i11.2584. ABSTRACT BACKGROUND: Emphysematous pyelonephritis (EPN) is a rare but fatal necrotic infection of the kidney, which usually leads to septic shock. Therefore, early diagnosis and optimized therapy are of paramount importance. In the past two decades, point-of-care ultrasound (POCUS) has been widely used in clinical practice, especially in emergency and critical care settings, and helps to rapidly identify the source of infection in sepsis. We report a rare case in which a "falls" sign on POCUS played a pivotal role in the early diagnosis of EPN. CASE SUMMARY: A 57-year-old man presented with fever and lumbago for 3 d prior to admission. He went to the emergency room, and the initial POCUS detected gas bubbles in the hepatorenal space showing a hyperechoic focus with dirty shadowing and comet-tail artifacts. This imaging feature was like a mini waterfa ll. His blood and urine culture demonstrated Escherichia coli bacteremia, and EPN associated with septic shock was diagnosed. The patient did not respond to broad-spectrum antibiotic treatment and a perirenal abscess developed. He subsequently underwent computed tomography-guided percutaneous catheter drainage, and fully recovered. We also review the literature on the sonographic features of POCUS in EPN. CONCLUSION: This case indicates that a "falls" sign on POCUS facilitates the rapid diagnosis of severe EPN at the bedside. PMID:33889624 | PMC:PMC8040185 | DOI:10.12998/wjcc.v9.i11.2584 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.