Emphysematous Pyelonephritis Caused by E.Coli and Candida Albicans with Oral Candidiasis and Herpes Genitalis: A Dreaded Infection PD01-PD03
Dr. Shyam Lal,
D-60-61, UGF ,F/S, Sewak Park Uttam Nagar, New Delhi, Delhi, India.
Emphysematous Pyelonephritis (EPN) is a rare, potentially fatal necrotising pyelonephritis, with rising trend in diabetic patients (95%). E.coli is the most common uropathogen whereas Candida albicans is extremely rare. Mortality in EPN, with present management techniques, is 18%. It should be suspected in diabetic patients with pyelonephritis. Splenic abscess is an uncommon association. Contrast Enhanced Computed Tomography (CECT) of abdomen is cornerstone for diagnosis. Nephrectomy is mainstay of treatment in extensive disease. Herein, we report a rare case of EPN in 58-year-old female who presented with diabetic ketoacidosis and septicaemia caused by E. coli and Candida albicans with superadded Herpes genitalis and oral candidiasis which is unique. Right nephrectomy was done. Postoperatively, she developed splenic abscess which was managed by percutaneous drainage.