Extensive emphysematous pyelonephritis leading to renal destruction

Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the kidney characterized by the presence of gas in the renal parenchyma, collecting system or perinephric tissues. It can be life-threatening if not recognized and treated promptly.We report the case of a 56-year-old woman, on treatment for diabetes mellitus, who presented with left-sided flank pain and fever. Computerized tomography revealed EPN with extensive destruction of the left kidney. Intravenous antibiotics were administered and left nephrectomy was performed. The postoperative course was uncomplicated, but during 4 months follow-up the patient’s renal function rapidly deteriorated. This case report emphasizes the need for appropriate management of EPN.