Acute pyelonephritis is a potentially organ-damaging and life-threatening infection. A 37-year old woman was admitted to Intensive Care Unit in septic shock and multi-organ failure due to acute pyelonephritis with systemic bacterial dissemination caused by a quinolone-resistant Escherichia coli. The patient, a previously healthy woman, reported recurrent episodes of urinary tract infection in the previous 3 years, which were treated with quinolones. Treatment course with broad-spectrum antimicrobial agents reversed her septic shock and multi-organ failure. However, pyelonephritis progressed to intrarenal and perirenal abscesses formation. The patient fully recovered after surgical removal of the infected kidney.
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