Bilateral emphysematous pyelonephritis with perirenal abscess cured by conservative therapy

Emphysematous pyelonephritis is a rare life-threatening infection of the re nal parenchyma. It usually affects unilateral kidney and occurs mostly in d iabetic patients. It is characterized by the presence of gas within the ren al parenchyma and requires prompt diagnosis and early aggressive therapy. B ilateral emphysematous pyelonephritis is even more rare and is associated w ith high mortality. We describe a case of a 62-year-old diabetic woman who presented with nonketotic hyperosmolar coma and bilateral emphysematous: py elonephritis caused by Klebsiella peumoniae. Diagnosis of bilateral emphyse matous pyelonephritis was confirmed by an abdominal computed tomographic sc an and microbiologic studies. Our patient was successfully treated using pe rcutaneous catheter drainage and long-term antibiotic therapy.