Emphysematous pyelonephritis

Case contributed by Pradosh Kumar Sarangi
Diagnosis certain


One week of left flank pain with fever and dysuria. 8 year history of diabetes mellitus, poorly controlled for 6 months.

Patient Data

Age: 50 years
Gender: Male

Left renal enlargement with architectural distortion. There are bubbly and linear streaks of air within renal parenchyma and perinephric space with an intrarenal fluid collection. Bilateral perinephric fat stranding and thickening of Gerota fascia noted (more in left kidney)

Case Discussion

The non-contrast CT findings in this diabetic patient with a history of fever, flank pain, leukocytosis, thrombocytopenia are consistent with emphysematous pyelonephritis. The perinephric collections and bubbly foci of air make this type 2, with a better prognosis.

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