This document defines emphysematous pyelonephritis as a life-threatening kidney infection seen predominantly in diabetics that is caused by gas-forming bacteria like E. coli. It presents with symptoms of kidney infection and potentially a flank mass. Diagnosis can be made through detection of gas pockets on imaging like ultrasound or CT. Treatment involves broad-spectrum antibiotics, drainage of any obstruction, and potentially nephrectomy for severe cases, as medical management alone has a high mortality rate of 60-80%.

2.  Def: Life-threatening necrotizing acute pyelonephritis and/or
obstruction, predominantly seen in diabetic patients
 Causes: Mostly gas-forming organisms such as Escherichia
coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and
Proteus mirabilis
 Symptoms of pyelonephritis and may be a flank mass.
 Urine analysis Pyuria and a positive urine culture

3.  Diagnosis: Gas pockets may be detected on plain abdominal
radiograph, ultrasound, or CT.
 CT is the diagnostic modality of choice
 Management: Parenteral broad-spectrum antibiotics and
percutaneous catheter drainage with relief of obstruction may
be adequate for less severely ill patients, but nephrectomy in
severely ill or not responding to other line of medication
o Medical treatment is associated with mortality of 60% to 80%,