Escherichia Coli–associated Emphysematous Pyelonephritis in Previously Undiagnosed Type 2 Diabetes Mellitus Requiring Nephrectomy: A Case Report and Review of Literature
Abstract
Emphysematous pyelonephritis (EPN) is a rare, life-threatening renal infection that is often associated with diabetes. This report describes a 59-year-old woman with neglected untreated type 2 diabetes who developed EPN caused by Escherichia coli and was complicated by sepsis and acute kidney injury (AKI). Unfortunately, the patient's condition deteriorated despite prompt conservative management with antibiotics, ureteral stenting, and strict glycemic control, as shown by imaging studies. Ultimately, laparoscopic right nephrectomy was performed, resulting in a clinical improvement and recovery. This case indicates that conservative management may fail even in lower-class EPN, particularly when risk factors such as thrombocytopenia and AKI are present.
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BibTeX
@article{niida2026escherichia,
title = {{Escherichia Coli–associated Emphysematous Pyelonephritis in Previously Undiagnosed Type 2 Diabetes Mellitus Requiring Nephrectomy: A Case Report and Review of Literature}},
author = {Yasuhiro Niida and Masakazu Uejima and Takuma Moriguchi and Ayame Takahashi and Taichi Deguchi and Kohei Morita and Shinsaku Nagamatsu and Hideki Matsuo and Kei Moriya},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.7421-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7421-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Escherichia Coli–associated Emphysematous Pyelonephritis in Previously Undiagnosed Type 2 Diabetes Mellitus Requiring Nephrectomy: A Case Report and Review of Literature
AU - Yasuhiro Niida
AU - Masakazu Uejima
AU - Takuma Moriguchi
AU - Ayame Takahashi
AU - Taichi Deguchi
AU - Kohei Morita
AU - Shinsaku Nagamatsu
AU - Hideki Matsuo
AU - Kei Moriya
PY - 2026
DA - 2026/08/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.7421-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7421-26/_article
AB - Emphysematous pyelonephritis (EPN) is a rare, life-threatening renal infection that is often associated with diabetes. This report describes a 59-year-old woman with neglected untreated type 2 diabetes who developed EPN caused by Escherichia coli and was complicated by sepsis and acute kidney injury (AKI). Unfortunately, the patient's condition deteriorated despite prompt conservative management with antibiotics, ureteral stenting, and strict glycemic control, as shown by imaging studies. Ultimately, laparoscopic right nephrectomy was performed, resulting in a clinical improvement and recovery. This case indicates that conservative management may fail even in lower-class EPN, particularly when risk factors such as thrombocytopenia and AKI are present.
SN - 1349-7235
SN - 0918-2918
ER -