Emphysematous pyelonephritis-related delayed abdominal wall necrotizing fasciitis: A case report.
Jacqueline Yu-Min Beh, Tung-Mao Lai, Dun-Hao Chang
✦ AI-curated · Sources linked
Case in brief
A 55-year-old woman with poorly controlled type II diabetes presented with emphysematous pyelonephritis (EPN) and required drainage. Two years later, she developed abdominal wall necrotizing fasciitis (NF) due to a chronic infectious pathway linked to her previous EPN. Imaging revealed gas-forming inflammation and a retained stent. After multiple surgical debridements and therapies, her infection resolved, and she was discharged after 58 days.
What made this case unusual
The case highlights the rare occurrence of delayed necrotizing fasciitis arising years after treated emphysematous pyelonephritis, emphasizing the need for vigilance in such patients.
Diagnostic / clinical pearl
Clinicians should consider the risk of delayed soft tissue infections in patients with a history of emphysematous pyelonephritis, especially with retained urinary stents.
Why it matters
This case underscores the importance of long-term monitoring for potential complications in patients with prior severe renal infections.