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Case Report
Septic shock secondary to xanthogranulomatous pyelonephritis: A case report and literature review
1 MD, General surgeon and laparoscopist, Division of General Surgery/Laparoscopy, Hospital General de Ciudad Juarez, Chihuahua, Mexico
2 MD, Urology surgeon, Division of Urology, Hospital General de Ciudad Juarez, Chihuahua, Mexico
3 MD, General surgeon and laparoscopist, Division of General Surgery/Laparoscopy, Centro Medico De Especialidades, Chihuahua, Mexico
4 MD, General surgeon resident, Division of General Surgery/Laparoscopy, Hospital General de Ciudad Juarez, Chihuahua, Mexico
Address correspondence to:
Cesar Alberto Lopez Jaime
Avenida Paseo Triunfo de la Republica, 32340 Ciudad Juárez, Chihuahua,
Mexico
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Article ID: 100042Z15CJ2024
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Lopez Jaime CA, Alonso Morales A, Perzabal Avilez CT, Hernandez Garza FN. Septic shock secondary to xanthogranulomatous pyelonephritis: A case report and literature review. J Case Rep Images Urol 2024;9(1):12–17.ABSTRACT
Introduction: Xanthogranulomatous pyelonephritis is described by histopathology as a destruction of the renal parenchyma and replaced by a chronic infiltrate of lipid-laden macrophages. It is known that patients with xanthogranulomatous pyelonephritis have a high rate of perioperative and postoperative morbimortality; however, there are few case reports on this entity.
Case Report: A 35-year-old woman attended the emergency department due to the presence of pain in the left flank, accompanied by an altered state of consciousness and respiratory distress. The study protocol started, identifying a significant increase in the left kidney, the presence of a central staghorn stone, dilated minor calices, and clinically with septic shock. The clinical conditions improved by adding intravenous fluids, vasoactive amines, red blood cells concentrates, and broad-spectrum antibiotics. Subsequently, a left nephrectomy was performed. On the following days, the septic shock gradually resolved, leading to the patient’s discharge. Eventually, histopathology report was reviewed, confirming a xanthogranulomatous pyelonephritis.
Conclusion: When a xanthogranulomatous pyelonephritis clinical suspicion is found, it is considered a surgical emergency. Furthermore, if proper management is not given immediately, there is a high risk of complications and death. However, the current statistics in Mexico have not been updated to contrast these data.
Keywords: Septic shock, Staghornn lithiasis, Xanthogranulomatous pyelonephritis
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Acknowledgments
We thank the staff of the “Hospital General de Ciudad Juarez” for their support and constant drive to learn.
Author ContributionsCesar Alberto Lopez Jaime - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Armando Alonso Morales - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Carlos Tadeo Perzabal Avilez - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Francisco Netzahualc Hernandez Garza - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Cesar Alberto Lopez Jaime et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
