Bilateral emphysematous pyelonephritis, a rare cause for acute renal insufficiency

Background: The emphysematous pyelonephritis is a life-threatening complica tion of a bacterial interstitial nephritis, and it occurs mainly in diabeti cs. The infection with optional anaerobic microorganism, which are able to produce gas, is supported by a reduced stare of resistance, a high glucose level in the tissue in diabetic derailment and ischemia in the infected org an, for example by a kidney infarction or by an obstructive uropathy. Mostl y the inflammation occurs unilateral, only in 10% of all cases both kidneys are affected. Computer tomography allows a fast diagnosis by demonstrating gas accumulation in the kidney. Surgical measures and antibiotic therapy a re the principal therapeutic methods. Case Report: The example of a 55-year-old diabetic man with bilateral emphy sematous pyelonephritis demonstrates the diagnostic and therapeutic possibi lities. After a fast diagnostic procedure, immediate hemodialysis in uremia and bilateral nephrectomy let the patient survive in a stable clinical con dition dependent on regular dialysis treatment.