Culture-Negative Emphysematous Pyelonephritis as a Complication of Uncontrolled Diabetes Mellitus: A Case Report

Cureus. 2022 Aug 10;14(8):e27856. doi: 10.7759/cureus.27856. eCollection 2022 Aug.

Abstract

Emphysematous pyelonephritis (EPN) is a severe, necrotizing infection of the renal parenchyma. It is commonly found as a complication of uncontrolled diabetes mellitus (DM). EPN has a terrible prognosis unless promptly identified and treated. In this case study, a 38-year-old man with type 2 diabetes mellitus (T2DM) was admitted due to complaints of excruciating abdominal pain, vomiting, and non-adherent to his insulin medication. The patient was subsequently diagnosed with EPN. For most patients, the current course of treatment includes nephrectomy along with antimicrobial medications. In this case report, however, the patient improved with conservative treatment such as IV fluids, antibiotics, and blood glucose control.

Keywords: acute kidney injury; antibiotic therapy; complicated pyelonephritis; e.coli; general internal medicine; general nephrology; hospitalized patients; infectious disease pathology; outpatient family medicine; uncontrolled diabetes mellitus.

Publication types

  • Case Reports