Is Aggressive Therapy the Answer for All Cases ofEmphysematous Pyelonephritis: A Report of Three Cases

Emphysematous pyelonephritis (epn) is a severe,necrotizing, life threatening infection of the renal parenchymaand management is not standardised due to scarcity ofliterature. we present 3 patients with this rare entity. all 3patients were of class iii on cect findings based on huang’sclassification and had more than two risk factors. our firstpatient underwent percutaneous drainage of his conditionupon which he recovered. the second and third patientsunderwent a laparotomy and nephrectomy. the secondpatient recovered after a stormy post operative period andthe third patient died. management of the first patient wascontrary to that recommended in literature, for the other twoit was as per recommendations. on successful managementof our first patient without surgery and seeing no discernablebenefits of surgery for our other two patients, it is possiblethat percutaneous drainage alone, coupled with antibioticsmay be a viable strategy for managing this condition withnephrectomy being considered as a second tier option.