Emphysematous Pyelonephritis

Abstract

Pictorial CME Emphysematous Pyelonephritis A forty eight year female, obese, diabetic for four years presented with high grade fever, vomiting and abdominal pain of six days duration. On examination she was toxic, febrile and hemodynamically stable. Abdominal examination revealed tenderness in the right lumbar region. Urine examination showed numerous pus cells, 1+ albumin, and positive ketones. Urine culture showed a growth of E. coli. Renal and liver functions were normal. Blood sugar (random) was 497 mg%. Plain Xray abdomen was normal. Ultrasound of abdomen was suggestive of hydronephrosis right kidney and dilated bowel loops. Contrast enhanced computerized tomography abdomen (Fig. 1) was characteristic of emphysematous pyelonephritis of right kidney. The left kidney was normal. Patient was managed by a combined medical and surgical approach (nephrectomy) and improved.