Emphysematous pyelonephritis of single kidney: Review of literature about one case

Introduction. - Emphysematous pyelonephritis is a rare and severe form of acute pyelonephritis. It is defined as the presence of gas-producing bacteria in the kidney and in peri-nepheretic areas. We report a case of emphysematous pyelonephritis on a single kidney associated with urolithiasis. Observation. - A 44-year-old woman, with a history of diabetes and chronic renal failure, presented with left renal colic, anuria, fever and worsening of general state. The diagnosis of emphysematous pyelonephritis was confirmed by CT scan. The treatment was based on anti-biotheray, adapted to the renal function, insulinotherapy and urine drainage by a double J stent. The evolution was favourable. Discussion. - Emphysematous pyelonephritis is an uncommon infection, generally affecting female diabetic patients. CT scan is mandatory to confirm diagnosis. Conclusion. - Even if it is rare, emphysematous pyelonephritis is associated with a high mortality in the absence of a rapid and effective treatment. (C) 2008 Elsevier Masson SAS et Association Societe de Nephrologie. Tous droits reserves.