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Emphysematous Pyelonephritis — SCE Infectious Diseases MCQ

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HardHealthcare-Associated InfectionsEmphysematous PyelonephritisSCE Infectious Diseases

A septic diabetic patient has gas in renal parenchyma and an obstructed collecting system. Which management component is indispensable?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Provide urgent urological source control plus intravenous antimicrobial and organ-support therapy with review

The best answer is “Provide urgent urological source control plus intravenous antimicrobial and organ-support therapy with review”. Emphysematous pyelonephritis with obstruction is a source-control emergency; drainage or nephrectomy is selected by anatomy, severity and response. “Use lithotripsy to remove gas bubbles” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Start dialysis as the sole infection treatment” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Use intravenous antibiotics alone despite obstruction and necrosis” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Manage as an outpatient with oral antibiotics” is less appropriate because it conflicts with the clinical discriminator or cited guidance.

Reference: EAU urological-infections guideline: https://uroweb.org/guidelines/urological-infections