A Case of Emphysematous Pyelonephritis.

J Assoc Physicians India

Published: November 2014

Emphysematous pyelonephritis is a rare but dangerous condition in patients with D.M. and urinary tract infection. We report a case of emphysematous pyelonephritis who presented to us with acute abdomen and sepsis. Her CT abdomen showed air in the collecting system of left kidney. She was managed with, I. V. fluids, antibiotics, insulin, and percutaneous nephrostomy. But she died on the 3rd day of hospitalisation due to Multiorgan failure with sepsis.

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Article Synopsis
  • Emphysematous pyelonephritis (EPN) is a severe urinary tract infection that can lead to high mortality rates, particularly in cases with underlying conditions, but it's rarely reported.
  • A 32-year-old pregnant woman with type 2 diabetes experienced worsening symptoms of pyelonephritis, leading to a diagnosis of EPN through imaging techniques.
  • Successful treatment involved antibiotic therapy, emphasizing the importance of early diagnosis and customized treatment approaches to safeguard both maternal and fetal health during pregnancy.
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Background Diabetes mellitus (DM) is a prevalent predisposing factor for urinary tract infections (UTIs). Among hospitalized patients with acute pyelonephritis, UTIs are more common, severe, and associated with worse outcomes, particularly in those with type 2 DM. Pyelonephritis in DM patients is more frequently bilateral and linked to greater complications, with 90% of emphysematous pyelonephritis (EMPN) and cystitis cases occurring in diabetic individuals.

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Clinical image: emphysematous pyelonephritis.

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Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.

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