الخلاصة

BACKGROUND: Emphysematous pyelonephritis is a life threatening necrotizing infection of the kidney characterized by accumulation of gas in the renal parenchyma as well as within the surrounding tissues(1,2). The common presentations are fever (56%), vomiting (16%), abdominal pain (7%), shock (16%) and confusion (24%) (1). The pathogenesis is poorly understood. the condition usually occurs in diabetic patients. Although glucose fermentation may be a factor, the explanation does not account for the rarity of emphysematous pyelonephritis despite the high frequency of gram-negative UTI in diabetic patients, nor does it explain the rare occurrence of the condition in nondiabetic patients. In addition to diabetes, many patients have urinary tract obstruction associated with urinary calculi or papillary necrosis and significant renal functional impairment.(3)