Emphysematous pyelonephritis, an uncommon severe necrotizing infection
of the kidney, usually associated with diabetes mellitus, is a potent
ially fatal illness. We present a case of a 75-year-old woman with dia
betes who was admitted with ''pyelonephritis.'' The computed tomograph
y scan of her abdomen revealed gas in the renal parenchyma, and emphys
ematous pyelonephritis was diagnosed. The patient had a total nephrect
omy, and was treated with antibiotics. Blood cultures and operative cu
ltures grew Escherichia coli.