Myceleal Emphysematous Cystitis Complicating a Renal Transplant

acutely ill with chills, fever and pain over the renal allograft. The symptoms had intensified over the past 3 days. At admission his temperature was 100.8 F, pulse-rate 110/min, BP 185/110, Hb 10.2, Hct 28, WBC 16200 (66 % polymorphs). BUN 140 mg/dL, CR 3.8 mg/dL, blood sugar 121 mg%. The patient had a history of poorly controlled hypertension for eight years and received a renal transplant for endstage renal disease some 10 months ago. The postoperative period was complicated by several episodes of LUTIs which were treated with amoxicillin and ciprofloxacin. Two months prior to this admission the patient had been treated for acute rejection and was still on maintenance immunosup-pressive therapy. Foley catheterization yielded onl