Emphysematous pyelonephritis presenting in acute respiratory distress syndrome: a case report

Abstract

Emphysematous pyelonephritis is a life-threatening infection of the kidneys characterized by acute necrosis with associated gas formation involving the renal parenchyma and perinephric tissues. It is a rare condition and occurs mostly in diabetic females, carrying a high mortality rate. The management involves antibiotics and surgical interventions. This is a case of an elderly lady, diabetic, who had fever and burning micturition and was initially treated with oral antibiotics. She later presented with fever, dyspnoea and dysuria, and was diagnosed to have emphysematous pyelonephritis with acute respiratory distress syndrome. She was successfully managed with broad spectrum antibiotics and percutaneous nephrostomy. As emphysematous pyelonephritis requires both medical and surgical interventions, this case, therefore, highlights the importance of its early detection, as it can be life-saving.