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Abstract Emphysematous pyelonephritis (EPN) is an acute necrotizing infectious disease of the collecting system, the renal parenchyma, and perinephric tissues. The current treatment methods include intravenous antibiotics, percutaneous drainage and nephrectomy. Here, we report a case of a female patient with uncontrolled diabetes mellitus (DM) who presented with EPN. Escherichia coli (E. coli) was the causative pathogen. Application of empirical simple antibiotic did not take a significant improvement of clinical manifestations. Combination of two kind of sensitive antibiotics, and appropriated invasive treatment based on the split-renal function assessment were suggested. Percutaneous drainage is helpful to improve clinical manifestations and achieve a better outcome. The split-renal function can be used to direct whether nephrectomy is necessary. If the split-renal function assessment provides support for nephron-sparing intervention, we should try our best to save it.
Liu et al. (Tue,) studied this question.