Xanthogranulomatous pyelonephritis presentation in the ED: a case report.

Xanthogranulomatous pyelonephritis (XGP) is a slowly progressive, chronic kidney infection. It presents with nonspecific symptoms and is definitively diagnosed by surgical examination. Xanthogranulomatous pyelonephritis must be differentiated in the emergency department (ED) from acutely progressive conditions, such as emphysematous pyelonephritis, which require immediate intervention. Xanthogranulomatous pyelonephritis requires nephrectomy; however, emergent kidney removal is not crucial. The low prevalence and nonspecific presentation of XGP increase the importance of recognizing common risk factors and comorbidities, such as type 2 diabetes, hyperlipidemia, and untreated urinary tract infections. Computed tomography (CT) scan is crucial in XGP assessment and should be obtained quickly upon presentation.