SIMULTANEOUS OCCURANCE OF EMPHYSEMATOUS PYELONEPHRITIS AND EMPHYSEMATOUS CHOLECYSTITIS IN AN UNCONTROLLED TYPE 2 DIABETIC: A CASE REPORT

Emphysematous pyelonephritis a life -threatening fulminant, necrotizing upper urinary tract infection associated with gas within the kidney. Which is a rare condition. Only 1-2 cases per year are encountered in a urological department in the United States. Emphysematous cholecystitis is a variant of acute cholecystitis which is generally caused by gas-forming organisms. This condition develops in approximately 1% of all cases of acute cholecystitis. Compared with typical acute pyelonephritis and typical acute cholecystitis, emphysematous pyelonephritis and emphysematous cholecystitis is associated with much higher rates of morbidity and significantly increased rates of mortality (15-25%). Individually these conditions are less reported, thereby, Simultaneous occcurance of emphysematous pyelonephritis and emphysematous cholecystitis are uncommon and only two cases are reported in literature. As clinical course of both entities are individually severe and life -threatening if not recognized and treated promptly, so in a case of simultaneous occurrence, early diagnosis is to be made and a potentially devastating outcome is to be avoided. We present a case of emphysematous pyelonephritis with emphysematous cholecystitis and pneumoperitoneum in a middle aged uncontrolled diabetic patient and discussed etio-pathogenesis, classification and therapy of these entities.