# Early Comprehensive Physiotherapy in Reconditioning Postoperative Emphysematous Pyelonephritis Patients: A Case Report

## TL;DR

A 69-year-old man with diabetes and emphysematous pyelonephritis improved after early physiotherapy following kidney surgery.

## Contribution

This case report demonstrates the effectiveness of early physiotherapy in postoperative recovery for emphysematous pyelonephritis patients.

## Key findings

- The patient showed improved chest expansion and reduced breathlessness after two weeks of physiotherapy.
- Functional capacity improved, as evidenced by the patient's ability to walk during the six-minute walk test.
- Early physiotherapy interventions helped manage pain and respiratory complications post-surgery.

## Abstract

In this case report, a 69-year-old man with a 25-year history of type 2 diabetes mellitus was admitted with severe symptoms like flank pain radiating to the groin, high-grade fever, hematuria, and respiratory symptoms, including shortness of breath and a productive cough. After a complete evaluation, he was diagnosed with emphysematous pyelonephritis (EPN), and to treat this condition, the patient underwent a surgery called percutaneous nephrolithotomy (PCNL), which is used to remove kidney calculi. EPN is a condition characterized by severe infection of the kidney tissue. After the surgery, the patient started experiencing respiratory distress, due to which he was referred to the cardiorespiratory physiotherapy department for further treatment. On the initial assessment, it was found that he had respiratory complications like reduced chest expansion, crackles heard in the lower part of his left lung, and moderate to severe breathlessness (Modified Medical Research Council grade III). A two-week physiotherapy program was planned for the patient, which focused on managing pain, improving chest expansion, clearing the airways, and increasing overall mobility. A few physiotherapy interventions were used, such as transcutaneous electrical nerve stimulation (TENS), deep breathing exercises, the active cycle of breathing technique, and early mobilization. After two weeks of rehabilitation, there was increased chest expansion and reduced shortness of breath and pain. He could also walk during the six-minute walk test (6MWT), which showed improved functional capacity. This case highlights the vital role of early physiotherapy in managing post-surgical complications and promoting early recovery in patients who have undergone PCNL surgery for EPN.