Emphysematous pyelonephritis - case report and evaluation of radiological features

Emphysematous pyelonephritis (EPN) is an acute necrotizing parenchymal and peri­renal infection caused by gas-forming uropathogens. The predisposing factors are diabetes mellitus and ureteric obstruction. E. coli is the most frequently identified pathogen. The overall mortality is 43%. Computerized tomography (CT) is the imaging procedure of choice in determining the extent of infection and guiding management. Management of EPN has evolved from aggressive surgical intervention to conservative management. Although there are reports of improved renal function after medical therapy combined with relief of obstruction, most of the patients still require neph­rectomy. We present a case of EPN and also evaluate the radiological features, prognosis, and current management of this disease.