World J Clin Med Case Rep | Volume 1, Issue 1 | Case Report | Open Access
Chaabouni H, Koubaa M, Hammami F*, Smaoui F, Rekik K, Marrakchi C and Jemaa MB
Department of Infectious Disease, Hedi Chaker University Hospital, University of Sfax, Tunisia
*Correspondance to: Fatma Hammami
Fulltext PDFIntroduction: Emphysematous Pyelonephritis (EPN) is a necrotizing gas producing infection of the renal parenchyma that commonly occurs in patients with diabetes. EPN requires early diagnosis and treatment due to the possible life-threatening septic complications.
Case Report: A 75-year-old female with Diabetes Mellitus (DM) was hospitalized for a 10-day history of fever, left flank pain and nausea. Physical examination of the patient showed fever and left flank tenderness. Laboratory investigations revealed elevated inflammatory markers and hyperglycemia. Computed Tomography (CT) of the abdomen showed a large, obstructing calculus in the lower-pole calyx of the left kidney, associated with gas in the left excretory cavities. The use of empiric antibiotics started with ceftriaxone and diabetes was controlled. Drainage was indicated using double-J ureteral catheter. Urine culture grew Candida glabrata. On day 7 of treatment with fluconazole, the patient presented thrombocytopenia, dyspnea and a reappearance of fever. It was thus replaced by Caspofungin. COVID-19 polymerase chain reaction test from a nasal swab was positive. Thoracic CT scan showed COVID-19 typical infiltrates with an estimated 10% involvement. The patient required oxygen and corticosteroid therapy. She also presented ionic disorders including hypokalemia and severe hypernatremia. The evolution was towards death.
Conclusion: EPN is a serious, systemic infection, with a high potential for complication and death. Fungal etiology should be ruled out for patients not responding to the initial antibiotics.
Emphysematous pyelonephritis; Diabetes; Candida glabrata; COVID-19
Chaabouni H, Koubaa M, Hammami F, Smaoui F, Rekik K, Marrakchi C, et al. COVID-19 and Emphysematous Pyelonephritis Caused by Candida glabrata: An Exceptional Entity. World J Clin Med Case Rep. 2023; 1(1): 1001..