title: Culture-negative bilateral emphysematous pyelonephritis presented as acute renal failure and managed medically only.
abstract: Emphysematous pyelonephritis is a life-threatening infection especially seen in patients with poorly-controlled diabetes mellitus. Imaging modalities (preferably computed tomography) are required to establish the diagnosis. Treatment modalities include volume resuscitation, broad-spectrum antibiotics, percutaneous drainage, and, as a last resort, nephrectomy. We present a case of a 46-year-old female who had hypertension and type-2 diabetes mellitus and presented with complaints of dysuria, back pain, and decreased urine output. Renal ultrasound and abdominal computerized tomography (CT) revealed air-fluid levels at each perirenal region and collecting systems, consistent with emphysematous pyelonephritis. Her clinical situation improved with vigorous fluid resuscitation and broad-spectrum antibiotic treatment.
authors.affiliation: Nephrology Department, Selcuk University, Meram School of Medicine, Meram, Konya, Turkey. yalcinsolakmd@gmail.com
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Solak
authors.forename: Kultigin
authors.initials: K
authors.lastname: Turkmen
authors.forename: Huseyin
authors.initials: H
authors.lastname: Atalay
authors.forename: Suleyman
authors.initials: S
authors.lastname: Turk
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004646:Emphysema / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy; D005188:False Negative Reactions; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008875:Middle Aged; D011704:Pyelonephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents