Emphysematous pyelonephritis developing in the contralateral kidney following ureteroscopy: An unusual presentation

Emphysematous pyelonephritis (EPN) developing in the contralateral kidney after ureteroscopic laser lithotripsy is an unusual clinical presentation and has never been reported in the literature. After ensuring sterile urine culture a 73-year-old female underwent left ureteroscopy, laser lithotripsy and stent placement for 15mm lower calyceal renal calculus. She was discharged same day and stent removed after 4 days. 1 week later she was admitted with sepsis and found to have EPN in the right kidney, with no evidence of stone or infection in the operated kidney. High index of clinical suspicion and prompt management resulted in successful outcome.