Case Report Open Access

Emphysematous Pyelonephritis with Abscesses Masquerading as an Ordinary Urinary Tract Infection

Tasnim F. Imran1, Frederick Yick1, Ahmed H. Qavi2, Sundar Dhamotharan1 and Steven J. Sperber3
  • 1 The State University of New Jersey, United States
  • 2 School of Medicine One Medical Center Drive Lebanon, United States
  • 3 University Medical Center 30 Prospect Ave Hackensack, United States


Emphysematous Pyelonephritis (EPN) is a rare, gas-forming infection of the renal parenchyma associated with significant morbidity and mortality. We report the case of a 39 year-old woman with uncontrolled diabetes who presented with abdominal pain, fevers and chills for one month. Physical exam was notable for dry oral mucosa and left costovertebral angle tenderness. Labs showed acute kidney injury and a hyperglycemic hyperosmotic state. CT abdomen revealed emphysematous pyelonephritis with a large left renal abscess. EPN should be considered in diabetic patients, especially those with uncontrolled or new-onset diabetes and those presenting with symptoms of urinary tract obstruction. Prognostic factors include thrombocytopenia, shock, altered mental status and need for hemodialysis. Our patient was treated successfully with intravenous antibiotics, percutaneous drainage, strict glucose control and monitored with serial imaging. She underwent laparoscopic nephrectomy one month later. Early diagnosis of EPN is essential as it carries a high mortality and a strong clinical suspicion is required, as patients may have an atypical presentation.

American Journal of Infectious Diseases
Volume 11 No. 4, 2015, 88-92


Submitted On: 16 March 2015 Published On: 22 October 2015

How to Cite: Imran, T. F., Yick, F., Qavi, A. H., Dhamotharan, S. & Sperber, S. J. (2015). Emphysematous Pyelonephritis with Abscesses Masquerading as an Ordinary Urinary Tract Infection. American Journal of Infectious Diseases, 11(4), 88-92.

  • 1 Citations



  • Emphysematous
  • Pyelonephritis
  • Diabetes Mellitus
  • Complicated Urinary Tract Infections