Unusual Emphysematous Chest Wall with Progressive Loculated Empyema and Abscess Formation Post Emphysematous Pyelonephritis: A Caes Report

Introduction The abdominal emphysematous pyelonephritis and its association with lung involvement in diabetic patients can be life treating and should be the cure as soon as possible. Case presentation Our case is a 39-year-old female patient with diabetes mellitus with a history of left kidney stones. She underwent extracorporeal shock wave Lithotripsy (ESWL) and a week later referred to the emergency room because of glucose 389 mg/dL, fever, and renal abscess. The infection then developed as emphysema around the kidneys and lungs and subsequent studies of urine sample test confirmed the infection with E-Coil. Following this parenchymal infection, the left kidney was destroyed and developed above the abscess diaphragm, and the left lung collapsed causing progressive emphysematous (PELE). The patient underwent the necessary diagnostic and therapeutic measures, including glycemic control and surgery thoracoabdominal incision with left nephrectomy, abscess drainage, and decortications. Eventually, the patient was discharged in good general condition. Conclusions In our case, auto-nephrectomy caused by pyelonephritis occurred in the context of diabetes and with a history of renal stone, so it seems that diabetic patients should also consider auto-nephrectomy in severe chronic and acute pyelonephritis infection.

کلیدواژه ها:

Progressive Emphysematous Loculated Empyema ، Emphysematous pyelonephritis ، extracorporeal shock wave lithotripsy