Emphysematous pyelonephritis - clinicorentgenologic diagnosis, requiring urgent surgical treatment. Case report

Emphysematous pyelonephritis is a rare and life-threatening suppurative infection of the renal parenchyma and the perirenal tissues, characterized by spontaneous gas production. Although uncommon, it occurs almost exclusively in diabetic patients (60-80% of the cases). We describe a recent case of a diabetic woman with emphysematous pyelonephritis, managed by unilateral nephrectomy. While the symptoms are usually general and nonspecific, the diagnostic approach is crucial in many cases. Ultrasonography should be the first diagnostic tool, as it is noninvasive, fast, and cost effective. However, CT scan is more specific and sensitive, and it should always be taken into consideration, as it enables the proper treatment decisions.Scripta Scientifica Medica 2008; 40(2): 145-147