Deriving a management algorithm for emphysematous pyelonephritis: Can we rely on minimally invasive strategies or should we be opting for earlier nephrectomy?

Patients with low-grade EPN may also have a high mortality rate. In the two cases who died, earlier consideration for nephrectomy may have been prudent. It may be beneficial to have a low threshold for prompt emergency nephrectomy in severe cases and where MIM treatment has failed. We suggest a management algorithm to guide clinicians and minimise mortality.