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Candida Albicans and Escherichia Coli Superinfection in Emphysematous Pyelonephritis: A Case Report of A Challenging

Daniel P Mujuni1, Abid M Sadiq1,2, Kajiru G Kilonzo1,2

  • 1Department of Internal Medicine KCMC University Moshi Tanzania.

Clinical Case Reports
|January 5, 2026
PubMed

Insights

Emphysematous pyelonephritis (EPN) is a severe kidney infection. This case highlights a rare fungal cause and the unpredictable, often fatal, course of EPN, even after initial treatment.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Emphysematous pyelonephritis (EPN) is a rare, necrotizing kidney infection with high mortality.
  • Commonly associated with type 2 diabetes mellitus (T2DM) and urinary tract obstruction.
  • Escherichia coli is the typical pathogen; fungal involvement is rare.

Purpose of the Study:

  • To report a rare case of EPN caused by Candida albicans.
  • To emphasize the unpredictable clinical course and challenges in managing EPN.
  • To highlight the importance of aggressive, multidisciplinary care, especially in resource-limited settings.

Main Methods:

  • Case report of a 66-year-old female with uncontrolled T2DM.
  • Clinical presentation suggestive of diabetic ketoacidosis and UTI.
  • Diagnosis confirmed by urine culture (Candida albicans) and abdominal CT scan showing renal gas.

Main Results:

  • The patient initially responded to medical therapy for EPN.
  • She later developed complications post-discharge, leading to a fatal outcome.
  • This case underscores the potential for sequential fungal-bacterial infections and unpredictable disease progression.

Conclusions:

  • EPN is a life-threatening condition requiring prompt intervention.
  • Fungal EPN, though rare, presents unique diagnostic and management challenges.
  • Vigilant, multidisciplinary management is crucial for improving outcomes in EPN, particularly during the post-acute phase.
Keywords:
Candida albicansEscherichia coliacute kidney injurydiabetes mellitusemphysematous pyelonephritissepsis

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