Pielonefritis enfisematosa: reporte de dos casos con manejo exitoso

Emphysematous pyelonephritis is a serious disease with an infrequent presentation and high mortality. It tends to occur more frequently in the population with risk factors, among which the following stand out: type 2 diabetes mellitus, obstructive uropathy, alcoholism, immunosuppression. The radiological classification of emphysematous pyelonephritis ranges from type one, which comprises gas that involves the collecting system, to type 4, which is a single or bilateral kidney disease.  Treatment will depend on the degree of severity, milder cases can be treated with catheter or percutaneous drainage plus antibiotic therapy, while more severe cases may require paranephrectomy surgery.  Patients with septic shock, thrombocytopenia, acute renal failure, and hypoalbuminemia generally have a poor prognosis.  We present two poorly controlled diabetic patients over 50 years of age diagnosed through computed tomography. One of the patients with obstructive uropathy and the other with horseshoe kidney, both patients successfully treated with medical management and minimally invasive procedure.