Emphysematous Nephritis

Abstract

The authors present a case of an 80-years-old male, suffering
from type 2 diabetes, with chronic indwelling urethral catheter, observed in the ER and showing prostration, fever, cloudy
and smelly urine for two days, lower abdominal pain without
signs of peritoneal irritation or palpable masses. He had high
inflammatory markers, renal dysfunction, and hyperkalemia.
The urinary exam showed leukocyturia without urinary nitrites.
Abdominal Computed Tomography revealed emphysematous
nephritis with gas accumulation in the parenchyma area and
a discrete gas area extending into the upper perirenal space
in the form of tiny gas bubbles and thickening of the perirenal
fascia. Afterwards, E. coli bacteremia was documented, sensitive to piperacillin/tazobactam which was administered, but
without any clinical improvement.