Clinics in diagnostic imaging (99). Left emphysematous pyelonephritis.

A 57-year-old woman, known to have diabetes mellitus, presented with a one-week history of fever, dysuria, and left flank pain. Computed tomography showed extensive left renal parenchymal destruction and a large gas collection. Urine culture revealed growth of Escherichia coli. The diagnosis of emphysematous pyelonephritis was confirmed at left nephrectomy. The clinical manifestations of emphysematous pyelonephritis, types of gas-forming renal infection, and their radiological findings are discussed.