A rare presentation of bilateral emphysematous pyelonephritis with concurrent lung abscess: A case report
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Wan Mohammad Noor Wan Amirul Asraf 1 , Razlina Abdul Rahman 1 , Mohd Noor Norhayati 1 , Imran Ahmad 1 *
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1 Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, MALAYSIA* Corresponding Author

Abstract

Bilateral emphysematous pyelonephritis (EPN) is a rare complication in uncontrolled diabetes mellitus patients and linked to a high patient mortality rate [1]. We present a case of a 62-year-old female patient with bilateral EPN who also developed a concurrent lung abscess. She came with high-grade fever, lethargy, and left flank pain. She had left lumbar tenderness and right-sided chest crepitations. Upon hospitalization, the patient developed septic shock. However, severity of her clinical presentation does not correlate with chest X-ray of right sided pneumonic changes and cavitation of the lungs on admission. Abdominopelvic computed tomography (CT) imaging revealed extensive left EPN (Huang-Tseng CT classification: class 4), early right EPN (Huang-Tseng CT classification: class 2), and right middle lobe lung abscess, which was treated with intravenous antibiotics, drainage, and optimal glycaemic management. This was followed by the resolution of sepsis and improvement in clinical status.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

ELECTRON J GEN MED, Volume 20, Issue 6, December 2023, Article No: em537

https://doi.org/10.29333/ejgm/13538

Publication date: 01 Nov 2023

Online publication date: 06 Aug 2023

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