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Diabetic ketoacidosis presenting with emphysematous pyelonephritis
Yara M Eid1, Mona M Abdel Salam
1Department of Internal Medicine, Division of Endocrinology and Metabolism, Ain-Shams University Hospitals, Abbassieh, Cairo, Egypt. yaraeid@asun.edu.eg <yaraeid@asun.edu.eg>
Journal of Diabetes and Its Complications
|February 24, 2009
Summary
A 28-year-old male with a history of diabetic ketoacidosis (DKA) presented with loin pain. Investigations revealed emphysematous pyelonephritis, a severe kidney infection.
Area of Science:
- Nephrology
- Infectious Diseases
- Endocrinology
Background:
- Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus.
- Urinary tract infections (UTIs) are common in diabetic patients.
- Emphysematous pyelonephritis is a rare but severe necrotizing infection of the renal parenchyma.
Observation:
- A 28-year-old Egyptian male presented with a 3-week history of left loin pain and DKA.
- The patient had a prior admission for UTI and DKA 5 months earlier.
- Clinical workup was initiated due to persistent symptoms and DKA.
Findings:
- Diagnostic investigations confirmed emphysematous pyelonephritis.
- This finding indicates a severe bacterial infection of the kidney in a patient with uncontrolled diabetes.
Implications:
- Prompt diagnosis and management of emphysematous pyelonephritis are crucial for patient outcomes.
- This case highlights the importance of glycemic control in preventing severe diabetic complications.
- Emphysematous pyelonephritis requires aggressive treatment, potentially including antibiotics and surgical intervention.
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