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Published on: July 18, 2017
Emphysematous pyelonephritis in a diabetic patient: A case report highlighting diagnostic challenges and successful
1Department of Infectious Diseases, The Fifth Clinical Medical College of Henan University of Chinese Medicine, People's Hospital of Zhengzhou, Zhengzhou, China.
Abstract:
Emphysematous pyelonephritis (EPN) is a rare, life-threatening necrotizing renal infection predominantly affecting diabetics. We report a 66-year-old female with uncontrolled type 2 diabetes who presented with right flank pain and fever. CT confirmed Class 2 EPN with gas confined to the renal parenchyma. Blood cultures grew Escherichia coli. She was successfully managed conservatively with imipenem-cilastatin, fluid resuscitation, and insulin therapy, avoiding surgery. This case highlights CT's role in early EPN diagnosis and demonstrates that tailored medical management can be a nephron-sparing alternative in selected patients.
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