Emphysematous pyelonephritis: A rare case report from Syria

INTRODUCTION: Emphysematous pyelonephritis is a rare necrotizing infection of the kidney. It should be diagnosed early because it has a bad prognosis. Treatments range from intravenous antibiotics to nephrectomy in severe cases. PRESENTATION OF CASE: A 67 years old female with uncontrolled diabetes mellitus presented with fever, right flank pain, and dysuria. Computed tomography for abdominal and pelvis showed gas inside the right kidney. After administration of intravenous antibiotics, she underwent right nephrectomy. Next, she was admitted to intensive care unit for monitoring. After three days, she was discharged with no complains. Follow-up for three months showed full recovery. CLINICAL DISCUSSION: Emphysematous pyelonephritis is an emergent condition. A history of uncontrolled diabetes mellitus with current flank pain with fever raises the suspicion. Computed tomography could be performed to confirm the diagnosis. CONCLUSION: Severe cases of emphysematous pyelonephritis are an emergent condition that needs nephrectomy.