Emphysematous Pyelonephritis Revealing Underlying Renal Tuberculosis: A Rare and Challenging Association

TL;DR

A rare case of emphysematous pyelonephritis complicated by tuberculosis is reported, emphasizing the need for accurate diagnosis to prevent unnecessary surgery.

Contribution

This case highlights the rare association of tuberculosis with emphysematous pyelonephritis.

Findings

EPN was initially caused by typical bacterial pathogens.

A superinfection with Mycobacterium tuberculosis occurred.

Early recognition of tuberculosis is crucial to avoid unnecessary nephrectomy.

Abstract

Emphysematous pyelonephritis (EPN) is a severe, necrotising infection of the renal parenchyma and surrounding tissues, most often accompanied by diabetes mellitus and Gram-negative bacilli. Tuberculosis superinfection is very rare, with only a few cases reported in the literature.

We present the case of a 61-year-old woman with multiple comorbidities, in whom emphysematous pyelonephritis (EPN) was primarily due to typical bacterial pathogens and subsequently complicated by a superinfection with Mycobacterium tuberculosis, highlighting the importance of recognizing this unusual secondary infection to avoid unnecessary nephrectomy.

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