Emphysematous pyelonephritis in a solitary kidney

A middle-aged female diabetic presented with ureteral obstruction, renal failure and emphysematous pyelonephritis in a solitary kidney. She was treated non-operatively with intensive antimicrobial therapy, prolonged ureteral catheter drainage and dialysis. Good recovery of renal architecture and function was eventually obtained. Although the usual indications for surgical extirpation or drainage of the kidney with emphysematous pyelonephritis seem to be well established circumstances may occasionally dictate an alternative course of action.