Left Emphysematous Pyelonephritis in a 44-year-old Female with Diabetic Nephropathy from a Tertiary Healthcare Facility in Southern Nigeria: A Case Report
Keywords:Diabetic nephropathy, fever, left emphysematous pyelonephritis
This is a case of a 44-year-old lady living with type 2 diabetes mellitus for 7 years with poor adherence to therapy and complicating diabetic nephropathy presenting with a 2 weeks’ history of high-grade continuous fever and left flank pain with associated nausea, vomiting and frothiness of urine. She denies previous urological disease. Physical examination revealed a moderately dehydrated, febrile (T=39.2̊ C) and pale young lady with tachycardia and tachypnea. Her left kidney was ballotable, tender with a positive punch sign on the left renal angle. Her urinalysis revealed numerous pus cells and leucocytes, her abdominal ultrasound revealed an enlarged left kidney measuring 15x7.58cm with irregular outline and areas of hyper-echogenicity within the cortical region casting dirty acoustic shadows in keeping with left Class 3A emphysematous pyelonephritis. Her abdominal CT further confirmed this diagnosis. She was managed conservatively with intravenous ceftazidime and Tinidazole with adequate fluid therapy. She was discharged home after 2 weeks of hospitalization. She is being followed up in the Nephrology clinic of our hospital.
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