ArticleMedicine2026
Emphysematous pyelonephritis with extensive gas accumulations in a patient with poorly controlled diabetes: A case report.
Article in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
rationaleEmphysematous pyelonephritis (EPN) is a rare but severe necrotic renal parenchymal infection with gas accumulation in the renal or extrarenal spaces. Patient could present as sepsis with a high mortality. Prompt diagnosis and treatments are essential to save the lives of affected patients. PATIENT CONCERNS: Here, we report a 64-year-old woman with poorly controlled diabetes. She presented with fever, progressive right flank pain, dysuria, urinary frequency, and urgency. DIAGNOSES: A computed tomography scan showed right renal parenchymal necrosis with extensive perinephric gas accumulation that extended inferiorly to the right ureter, bladder, and right iliac fossa, posteriorly to the bilateral psoas and erector spinae muscles, and superiorly to the perihepatic space, mediastinum, left shoulder, and left side of the neck. The massive extent of the gas accumulation was rarely reported previously. EPN was diagnosed.
interventionsShe received intravenous antibiotics, blood glucose control and percutaneous drainage. OUTCOMES: She successfully recovered after a series of treatments. LESSONS: Early identification and initiation of etiological treatment, as well as symptomatic treatment for EPN are crucial for saving patients' lives.
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