Diabetic patient with severe right loin pain and abdominal swelling.
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Enlargement and destruction of the right kidney which is replaced by large amount of mottled air with necrotic renal tissue within. The air almost fills also the renal pelvis, upper 1/2 segment of the right ureter. Additional smaller stone.
Diagnosis: Emphysematous pyelonephritis type I
Diabetes mellitus is a risk factor for emphysematous pyelonephritis as well as the immunocompromised.
E. coli is the commonest organism. It is associated with bad prognosis.