TY - JOUR T1 - Emphysematous Pyelonephritis and Emphysematous Cholecystitis: A Result of Uncontrolled Type 2 Diabetes JF - Ochsner Journal JO - Ochsner J SP - 316 LP - 318 DO - 10.31486/toj.20.0126 VL - 21 IS - 3 AU - Fred Alain Montelongo-Rodríguez AU - José Iván Robles-Torres AU - Jesús García-Saucedo AU - Efraín Ruíz-Galindo AU - Carlos Pacheco-Molina AU - Lauro Salvador Gómez-Guerra Y1 - 2021/09/21 UR - http://www.ochsnerjournal.org/content/21/3/316.abstract N2 - Background: Emphysematous pyelonephritis (EPN) is a life-threatening necrotizing infection that results in the presence of gas in the renal parenchyma, collecting system, and surrounding tissues. Up to 95% of patients with EPN have underlying uncontrolled diabetes mellitus. Emphysematous cholecystitis (EC) is a necrotizing infection defined by the presence of gas in the gallbladder. Concurrent presentation of EPN and EC is limited to anecdotal cases in the literature.Case Report: We present the case of a 44-year-old female who arrived at the emergency department with signs of septic shock and diffuse abdominal pain. Diagnosis of EPN and EC was confirmed. Because the patient did not improve after aggressive medical therapy and percutaneous drainage and cholecystostomy, she was taken to surgery for emergency nephrectomy and cholecystectomy.Conclusion: In unusually extensive and severe cases of EPN, medical and minimally invasive procedures are not enough to control the infection. More aggressive management, including emergency surgery, should be implemented in selected patients who present with refractory septic shock associated with extensive disease. ER -