糖尿病に合併した気腫性腎盂腎炎

EMPHYSEMATOUS PYELONEPHRITIS ACCOMPANIED WITH DIABETES MELLITUS: REPORT OF A CASE

　68歳，女性．以前より糖尿病を指摘されていたが，特に治療は受けていなかった．発熱および意識障害にて来院，敗血症と糖尿病性ケトアシドーシスの診断で入院した．腹部単純X線写真とCTにて右腎気腫性腎盂腎炎と診断し，高血糖のコントロールおよび緊急右腎摘出術にて軽快した．尿路の閉塞は見られず起炎菌はE．coliであった．

A 69-year-old woman was hospitalized with spiking fevers, disorientation and seizures. Diabetes mellitus has been diagnosed one year prior to admission but she had chosen not to be treated. On the second day of hospitalization she developed abdominal distension with right flank pain. KUB revealed gas around the right kidney and CT scan demonstrated the right perinephric gas collection and parenchymal destruction in the kidney. A diagnosis of right emphysematous pyelonephritis was made. A right nephrectomy was carried out. No stones or urinary tract obstruction were found.