WCN26-8177 Acute Kidney Injury Due to Rickettsial Infection - Data from a Tertiary Care Centre in Southern India

obstruction in 60-75% of patients, predominantly due to urolithiasis.The clinical triad of fever (79-100%), flank pain (50-71%), and nausea/vomiting (17-50%) constituted the most common presenting symptoms.Laboratory findings revealed leukocytosis in 83% of patients, thrombocytopenia in 26-33%, and acute kidney injury in 59-75% of cases.Escherichia coli was isolated in 69-80% of urine or pus cultures, followed by Klebsiella pneumoniae (11-20%), Proteus mirabilis (5-11%), and other pathogens.According to the Huang-Tseng classification system, 60-75% presented with Class 1 or 2 disease, 15-25% with Class 3A or 3B, and 10-13% with Class 4 bilateral EPN.Treatment consisted of broad-spectrum antibiotics combined with percutaneous drainage or DJ stenting in 70-80% of cases.Nephrectomy was required in 6-22% of patients who failed conservative management.The overall mortality rate was 10.6-19%.Independent predictors of mortality included Huang-Tseng Class 3B or 4 disease, thrombocytopenia, acute kidney injury requiring hemodialysis, septic shock, and presence of two or more risk factors (platelet count <150,000/L, altered consciousness, acute renal failure, and shock).Conclusion: EPN remains a challenging urological emergency with substantial mortality despite contemporary management strategies.Early recognition, aggressive resuscitation, appropriate antibiotic therapy, and timely drainage procedures constitute the cornerstone of management.The Huang-Tseng classification system effectively stratifies disease severity and guides therapeutic decisions.Conservative management with percutaneous drainage achieves renal preservation in the majority of cases, reserving nephrectomy for patients with extensive disease or those failing minimally invasive interventions.Diabetes mellitus and urinary obstruction remain the primary modifiable risk factors, emphasizing the importance of glycemic control and prompt relief of urinary tract obstruction in prevention and management.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.