Emphysematous Pyelonephritis with Fever, Jaundice and Urinary Obstruction; a Case Report

Emphysematous pyelonephritis (EPN) is a urologic emergency, which needs immediate medical attention. It is a life-threatening gas-producing infection affecting the renal parenchyma. In this study, we present a 35-year-old male Afghan patient, who was admitted to the Emergency department with low-grade fever, jaundice, abdominal pain, nausea and vomiting, burning urine, and obstructive urinary symptoms. His laboratory data showed serum creatinine 5.4 mg/dl, bilirubin 10.4 mg/dl and thrombocytopenia. Abdominopelvic computed tomography (CT) scan showed gas in the right renal parenchyma and the patient was sent to the operation room with diagnosis of EPN and emergency cystostomy and nephrectomy were performed. The patient was discharged one week later in good condition. Voidingcystogram and retrograde urethrogram were scheduled and performed 2 months later, which revealed long anterior urethral stricture. Anterior urethroplasty with buccal graft was successfully performed later.