Emphysematous pyelonephritis in a patient infected with the human immunodeficiency virus

Emphysematous pyelonephritis (EPN) is a rapidly progressive and life-threatening infection that is seen most commonly in persons with diabetes. The infecting organisms usually consist of mixed flora,including Escherichia coli (68%),Klebsiella pneumoniae (9%) and Proteus mirabilis. Females are affected twice as often as men,and mortality rates can be as high as 80%. Obstructive uropathy,urinary calculi,calyceal stenosis and neoplasms are significant predisposing factors. We report a case of EPN in a patient with the human immunodeficiency virus infection,without diabetes mellitus or urinary tract obstruction,which responded remarkably to conservative management with antibiotics alone.