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61歳,女性。発熱,悪心・嘔吐・意識障害にて来院した。諸検査にて、機能的単腎,糖尿病に合併し,E.coliを起炎菌とした右気腫性腎盂腎炎と診断した。敗血症性ショック,DIC,急性腎不全を併発しており,血液透析を含めて保存的治療の後,後腹膜ドレナージ,右腎摘除術を施行した。以後,週2回の血液透析にて経過良好である。
A 61-year-old diabetic woman was hospitalized with high fever, nausea, vomiting, and disorientation. She had urinary tract infection accompanied with sepsis, disseminated intravascular coagulation and renal dysfunction. Radiological findidngs disclosed left atrophic kidney and evidence of gas at intrapelvic and perinephric space of the right kidney. A diagnosis was made of right emphysematous pyelonephritis. Renal function was gradually worsening and hemodialysis was performed. After the drainage of right perinephric space with improved patient's condition, right nephrectomy was perfomed.
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