Bilateral emphysematous pyelonephritis cured by antibiotics alone: a case and literature review

Emphysematous pyelonephritis (EPN) is a rare but severe infectious disease. This disease sometimes presents bilaterally, making it difficult to cure. Diabetes mellitus is a common cofactor in this disease. Drainage or nephrectomy, often combined with antibiotics, is ordinarily used for treatment. To our knowledge, only 8 cases of bilateral EPN cured by antibiotics alone have been reported. We report the case of an 86-year-old woman with bilateral EPN cured by antibiotic therapy alone, thus avoiding surgery or drainage in a frail elderly patient.