Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of renal parenchyma and urinary tract, characterized by the presence of gas 1-9. The first description of this entity by Kelly and MacCallum was in 1898, and in 1962 Schultz and Klorfein coined the term emphysematous pyelonephritis 3,4. EPN risk factors are diabetes mellitus and obstructive uropathy; severe uterine prolapse, giant fecaloma, and immunosuppression are also cited 1-9. Females in the sixth decade of life are more frequently affected, and clinical manifestations include fever, nonspecific abdominal and/or flank pain, dysuria, pollakiuria, septicemia, and hypotension that may evolve to septic shock 1-9. Uncommon complications of EPN include psoas abscesses, pneumorachis, pneumomediastinum, spondylodiscitis, and emphysematous osteomyelitis 4,9.
