BILATERAL EMPHYSEMATOUS PYELONEPHRITIS

Emphysematous pyelonephritis is a severe disease characterized by the presence of gas in the renal parenchyma, peri-renal space or urinary t ract as a result of an infectious process caused in most cases by anae robic facultative gram-negative bacilli. This infrequent disease affec ts almost exclusively patients with obstructive uropathy and/or diabet es mellitus. The mortality is high and a nephrectomy is often necessar y. Bilateral involvement is rare. We report the case of a young diabet ic man with obstructive uropathy who suffered from bilateral emphysema tous pyelonephritis. Ultrasonography failed to make the diagnosis. The patient had a favorable evolution after a left nephrectomy and right urinary tract drainage. We have reviewed the most relevant aspects of this severe disease, with special attention to prompt diagnosis and tr eatment because of its importance in the prognosis.