Emphysematous pyelitis in a solitary functioning kidney

Emphysematous pyelonephritis on a single anatomic kidney: About a case report and literature analysis

Emphysematous pyelonephritis (EPN) on a single kidney is an extremely uncommon necrosing infection of renal parenchyma due often to infection by a gas-producing bacteria in a patient with uncontrolled diabetes mellitus. The management associate aggressive fluid and electrolyte resuscitation with several dialysis sessions, control of blood sugar levels, and broad-spectrum antibiotics with an urgent drainage. This paper aims to describe a case of a 68-year-old diabetic male patient who presented with EPN on a single kidney managed by conservative treatment.

Asymptomatic emphysematous pyelitis-a rare clinical entity

A 62-year-old asymptomatic woman with diabetes was referred to the urology department from nephrology due to deterioration in renal function with accompanied right-sided hydronephrosis on ultrasound. CT imaging subsequently revealed a right-sided staghorn calculus and a significant volume of gas in the right collecting system from the kidney to the distal ureter, in keeping with emphysematous pyelitis. She was admitted and managed with antibiotics and insertion of right nephrostomy in the first instance, followed by percutaneous nephrolithotomy to definitively manage the stone. The patient remained asymptomatic throughout the process.