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Emphysematous pyelonephritis

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Diabetic patient with severe right loin pain and abdominal swelling.

Patient Data

Age: 50 years
Gender: Female

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

Case Discussion

Diabetes mellitus is a risk factor for emphysematous pyelonephritis. Patients who are immunocompromised are also at risk.

E. coli is the commonest organism and is associated with a poor prognosis.

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