Dr. Ajay Budhwar, Dr. Parul Malhotra


Emphysematous pyelonephritis is a gas producing, necrotizing infection involving the renal parenchyma and, in some cases, perirenal tissue. It
usually presents with fever, chills, pyuria, back pain or flank pain with abrupt onset of symptoms, however, nausea, vomiting, shock and crepitus
overlying affected kidney are also common. It can be associated with diabetes or underlying obstructive uropathy in non diabetics. More than 90%
of cases of EPN occur in diabetic patient. It may also occur in immunocompromised people, alcoholic individuals, ureteral obstruction, urinary
tract infection and hydronephrosis [2] Computed tomography (CT) remains the optimal diagnostic radiological investigation. Escherichia coli is
the most common causative pathogen isolated on urine or pus culture in nearly 70% of the reported cases, Klebsiella pneumoniae (29%), Proteus,
Streptococci or mixed organism (10%). [3]Aggressive treatment with broad spectrum antibiotics is recommended along with Percutaneous
drainage(PCD).. The case described is an unusual case of diabetes mellitus presenting as emphysematous pyelonephritis


Emphysematous Pyelonephritis, Diabetes Mellitus, Antibiotic, Insulin, Pcd

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