Emphysematous pyelonephritis: A new case and review of previous observations

An example of emphysematous pyelonephritis caused by Escherichia coli in a twenty year old diabetic woman is presented. The gas was present within the kidney for forty-three days despite antibiotic therapy, and several roentgenographic technics were utilized to demonstrate the lesion. At the time of operation a large gas-filled abscess was seen, as well as necrotizing pyelonephritis and medullary necrosis. Described herein is a concept of this disease which emphasizes the invariable association with infection combined with a local or systemic condition which compromises the resistance of the host, allowing uncontrolled proliferation of gas-forming organisms.