title: [Serious complications of urinary tract infection in diabetes: emphysematous pyelonephritis and endogenous endophthalmitis].
abstract: BACKGROUND
  Patients with poorly regulated diabetes mellitus may develop severe infectious complications. In this article we describe a diabetic patient with urosepsis, complicated by emphysematous pyelonephritis and endogenous endophthalmitis.
  
  
  METHODS
  A 42-year-old diabetic woman presented with drowsiness and flank pain at the right side. She turned out to have diabetic ketoacidosis and urosepsis caused by Escherichia coli. Ultrasonography and CT scan of the abdomen showed subcapsulary gas configurations in the right kidney, which fit with the diagnosis of emphysematous pyelonephritis. Two days later, the patient complained of severe pain of the left eye with photophobia and blurred vision. The diagnosis of endogenous endophthalmitis was made. Treatment consisted of vitrectomy of the left eye, silicone oil injection and intravitreal and systemic antibiotics. The pyelonephritis was treated with antibiotics and percutaneous drainage.
  
  
  CONCLUSIONS
  Both endogenous endophthalmitis and emphysematous pyelonephritis are rare complications of infection, which can result in severe damage to the eye and kidney. Treatment comprises both local and systemic therapy. With the increasing number of diabetics, we can expect more rare complications.
authors: Onze Lieve Vrouwe Gasthuis, Amsterdam. michelleklouwens@hotmail.com
authors: Michelle J
authors: MJ
authors: Klouwens
authors: Willem L
authors: WL
authors: Blok
authors: Antonella N
authors: AN
authors: Witmer
authors: C J W
authors: CJ
authors: Verouden
authors: Marco
authors: M
authors: Mura
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D048909:Diabetes Complications; D009877:Endophthalmitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004927:Escherichia coli Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D011704:Pyelonephritis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014552:Urinary Tract Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents