Emphysematous Pyelonephritis In Type II Diabetes: A Case Report

Emphysematous pyelonephritis (EPN) is a severe acute necrotizing infection of the renal parenchyma and peri-renal tissue, characterized by gas formation. 90% of cases are seen in association with diabetes mellitus. EPN carries a mortality of up to 40% with medical management alone. Early recognition of EPN in an obstructed kidney is essential to guide aggressive management, and in the presence of continued severe sepsis or organ dysfunction an urgent nephrectomy should be carried out. Diabetic patients who are known to have renal or ureteric calculi, irrespective of their symptoms should be considered for percutanous or ureteroscopic treatment. We report an interesting case of EPN, which responded very well to obstruction release and aggressive antibiotics.