気腫性腎盂腎炎の1例

EMPHYSEMATOUS PYELONEPHRITIS : A CASE REPORT

　70歳，女性．全身浮腫，傾眠状態を主訴として本院受診．入院時血糖値777mg／dlであったため糖尿病の治療を開始した．血糖値の改善にもかかわらず全身状態は増悪し，血管内凝固症候群を併発した．腹部CTで右腎の腎盂内，腎実質内，一部腎周囲にガス像が認められ，気腫性腎盂腎炎と診断した．経尿道的ドレナージ，化学療法により右腎内外のガス像は消失した．

A 70-year-old female was admitted because of edema and somnolence. As her blood sugar concentration was 777 mg/dl, treatment was focused on the control of blood sugar and intravenous fluid administration. The patient's condition, however, deteriorated rapidly and became complicated with septic shock and disseminat-ed intravascular coagulation. CT scan showed gas in the right renal pelvis, renal parenchyma, and around the kidney. After transurethral drainage and intensive antibiotic therapy, the gas in and around the right kidney completely disappeared.