Emphysematous pyelonephritis complicated by septic shock treated with antibiotic therapy alone: a case report

Abstract

Introduction and importance: Emphysematous pyelonephritis (EPN) is a rare and serious complication of urinary tract infections that mainly occurs in diabetic patients. It results in the development of aerobic gas-forming bacteria1. Diagnosis is based mainly on a computed tomography scanner. Therapeutic management is based on the patient’s clinical condition and radiological classification. Case presentation: We present a case of a 64-year-old female patient with type 2 diabetes under insulin and hypertension under amlodipine, who was admitted to the intensive care unit for a state of septic shock on EPN. The patient received resuscitation measures and antibiotic therapy, and the evolution was favorable. The patient was transferred to the urology unit after 10 days of hospitalization in the intensive care unit. Discussion: EPN is frequently caused by gram-negative cocci and generally develops in diabetics. The clinical signs of EPN are not very specific and are essentially based on the signs of acute pyelonephritis, which responds badly to treatment. Conclusions: It is essential to take preventive measures in diabetic patients to avoid this complication. Early diagnosis allows for avoiding surgery by preserving the kidney.