Emphysematous Pyelonephritis Presenting as Pneumomediastinum: A Rare Case Scenario

Emphysematous pyelonephritis (EPN) is characterized by fulminant necrotizing infection of the kidney and perirenal tissues. Emphysematous pyelonephritis presenting as pneumomediastinum is quite rare. A 65-year-old gentleman presented to us with respiratory failure on ventilator support and uncontrolled sugars. He had fever with chills, abdominal pain, and breathlessness. He was evaluated and computed tomography showed right Huang et al. class 3 EPN with pneumomediastinum. He also had renal failure, respiratory distress syndrome, and metabolic acidosis. Pigtail drainage of right EPN was performed. He succumbed to the disease despite treatment. This case highlights the rare presentation of EPN as pneumomediastinum.

Karthikeyan VS, Mohan V, Narayanan J, Karthikeyan A. Emphysematous Pyelonephritis Presenting as Pneumomediastinum: A Rare Case Scenario. Indian J Crit Care Med 2020;24(4):281-282.