Fulminant emphysematous pyelonephritis (EPN) in a diabetic patient suspected of having multiple tumors.
Multiple tumors in the liver, kidney, and on the posterior side of the urinary bladder were accidentally found when a diabetic woman visited the hospital. She refused to undergo surgery; therefore, she was only observed for 2 months. Subsequently, she was found unconscious at home and diagnosed with urinary infection, sepsis, and hyperglycemic hyperosmolar non-ketotic coma. The case followed a fulminant course, and she soon died. Postmortem computed tomography revealed emphysematous pyelonephritis (EPN), a rare, life-threatening infection. This case highlights the importance of carefully managing infection in diabetic patients, and it may contribute to clarifying the pathogenesis of EPN.
Division of Metabolism and Endocrinology, Department of Internal Medicine, Juntendo Urayasu Hospital, Urayasu. jsato@juntendo.ac.jp
Junko
J
Sato
Hajime M
HM
Koyano
Ruri
R
Sasaki
Yoshie
Y
Koike
Sosuke
S
Sugimura
Hirotaka
H
Watada
D048909:Diabetes Complications / Q000175:diagnosis / Q000209:etiology; D003928:Diabetic Nephropathies / Q000150:complications / Q000175:diagnosis*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D011704:Pyelonephritis / Q000175:diagnosis* / Q000209:etiology