Emphysematous Pyelonephritis

Dr. Hill presented a very interesting case of a patient with history of poorly controlled diabetes and urinary retention who was initially admitted with severe sepsis due to a presumed complicated urinary tract infection. The patient’s hospital course was complicated by recurrent fevers even 48-72 hours after antibiotics were started.

Dr. Riquelme reviewed a nice framework for thinking about causes of ongoing GU infections by thinking through the anatomy of the GU tract:

  • Prostatitis

  • Unresolved bladder outlet obstruction

  • Nephro/ureterolithiasis as a nidus of infection or causing pyonephrosis

  • Pyelonephritis

  • Perinephric abscess

Thanks to Dr. Hill’s case, we also have one more to add to our differential: