A case of emphysematous pyelonephritis induced by Citrobacter freundii infection
A 79-year-old female with diabetes mellitus and hypertension had general fatigue, high fever and vomiting, was transferred to our hospital. She was experiencing a state of systemic inflammatory response syndrome and had lower abdominal tenderness. A computed tomography (CT) scan for detection of the septic focus suggested acute emphysematous pyelonephritis (EPN) []. She was treated conservatively, however, her condition did not improve, so an urgent right nephrectomy was performed on the 2nd hospital day. The results of the blood and urine culture showed the presence of Citrobacter freundii infection. The patient's post-operative course was uneventful and discharged on foot.\nThis case is the second reported case of EPN induced by C. freundii.[] Bacteremia induced by C. freundii infection typically results in a high mortality rate. In this case, early diagnosis of EPN using CT and immediate medical treatment, including urgent elective nephrectomy, was key to the favorable outcome.