Presentation
Fever, flank pain, diabetes.
Patient Data
Gender: Male
From the case:
Emphysematous pyelonephritis
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Right renal parenchyma largely replaced by gas, with a small amount in the collecting system. Retroperitoneal gas extends to the left retroperitoneum and mediastinum.
Case Discussion
Life-threatening necrotizing infection most common in diabetics. Requires aggressive medical management and often nephrectomy. E coli, Klebsiella pneumoniae, and Proteus mirabilis are most common organisms. A less severe subtype has nephric/perinephric collections with gas rather than such extensive parenchymal destruction with gas as in this case.
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