Today’s nightmare endourology case
By Thomas Johnston and Stephen Keoghane
An 80-year-old woman presented with #urosepsis requiring direct admission to intensive care. A CT scan demonstrated gas in the collecting system and a #nephrostomy was inserted.
The patient made a good recovery from her life-threatening sepsis, retaining function on a DMSA scan and underwent a flexible ureteroscopy to clear the stone. Gas forming organisms in the urinary tract result in dramatic imaging but should not distract from the patient’s clinical condition. A conservative approach may avoid a nightmare #nephrectomy in a highly morbid patient.
Learning points
Gas forming infection in the collecting system is a dramatic finding on imaging. Management may not need to differ from non-gas forming urinary tract infection.