Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma, which has been traditionally treated with surgical management. Emphysematous pyelonephritis presents clinically with varying degrees of renal failure, delirium, metabolic acidosis, septic shock, and hyperglycemia. Computed tomography is needed in most cases for diagnosis and staging of the disease. We report a case of emphysematous pyelonephritis successfully treated medically with the institution of early goal-directed therapy with only antibiotics and activated protein C, without the need for even percutaneous drainage.
From the *Northeastern Ohio Universities Colleges of Medicine and Pharmacy, Rootstown and †Department of Internal Medicine, Western Reserve Care System, Youngstown, Ohio.
Correspondence to: Abhijit Duggal, MD, MPH, Department of Internal Medicine, Western Reserve Care System, 500 Gypsy Lane, Youngstown, Ohio 44504. E-mail: firstname.lastname@example.org.
Drs Duggal, Koury, and Waraich have no personal or financial support or involvement with any organization with financial interest in the subject matter or any actual or potential conflict of interest.
This work was performed at Western Reserve Care System/NEOUCOM, Youngstown, Ohio.