Emphysematous pyelonephritis

Case contributed by Dr Ian Bickle

Presentation

A middle aged female presents with left flank pain and a mild fever.

Patient Data

Age: 50
Gender: Female
CT

Calculus in the left renal pelvis.

The calyces are dilated with foci of gas within the collecting system and renal parenchyma.

Thinning of the left renal cortex.  No peri-nephric collection.

Case Discussion

This is a case of emphysematous pyelonephritis.  This constitutes only a small percentage of pyelonephritis, largely occurring in diabetic patients and others with an immunosuppressive state.  E. coli is a the commonest responsible organism.

It is most commonly depicted on CT - the gas component being very difficult to observe on ultrasound, even though this modality is very frequently first performed.

Urolithiasis is very often observed in this group of patients, as in this case.

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Case information

rID: 24370
Case created: 10th Aug 2013
Last edited: 7th Jun 2016
System: Urogenital
Inclusion in quiz mode: Included

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