[A case of emphysematous pyelonephritis successfully treated by multiple CT-guided percutaneous drainage procedures]

A case of emphysematous pyelonephritis successfully treated by multiple, computed tomography (CT)- guided, percutaneous drainage procedures. A 63-year-old female with complaints of high-grade fever and vomiting was transferred to our hospital with leukocytosis and hyperglycemia. CT revealed a gas shadow widespread not only in the left renal parenchyma but also in the retroperitoneal space with extension to the right pararenal space. Under a diagnosis of emphysematous pyelonephritis, CT-guided percutaneous drainage was performed immediately, and a drainage catheter was placed in the retroperitoneal space. However, because a single drainage with medical management was not completely effective, a second drainage procedure was performed. She recovered, and the catheters were removed after four months. A left perinephric abscess and cutaneous fistula formation were localized and almost completely resolved after one year.