Grand Journal of Urology
E-ISSN : 2757-7163

Coexistence of Emphysematous Pyelonephritis Related to Renal Tuberculosis, Iliopsoas Abscess and COVID-19 Pneumonia Presenting as Diabetic Ketoacidosis: A Case Report and Review of the Literature
Muge Bilge1, Isil Kibar Akilli2, Furkan Isgoren1, Furkan Kizilisik1, Burak Cakici1, Samet Ercan1, Ugur Aydin1, Busra Bulut1
1Department of Internal Medicine, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
2Department of Pulmonary Disease, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
DOI : 10.5505/GJU.2022.57441
Pages : 080-084
Concurrence of emphysematous pyelonephritis related to renal tuberculosis and iliopsoas abscess is exceedingly rare, and its coexistence with COVID-19 pneumonia presented as "diabetic ketoacidosis" may have fatal consequences. A 46-year-old diabetic female patient was manifesting signs of septic shock; unconsciousness, febrile episodes, tachycardia and tachypneia when she was first admitted to our emergency department. She had positive real-time PCR test results for COVID-19 four days before her admission with symptoms of abdominal pain, fever, nausea, weakness, chest tightness, and shortness of breath persisting for a week. Blood test results were consistent with diabetic keto acidosis. Computed tomography (CT) showed left-sided emphysematous pyelonephritis and iliopsoas abscess. The patient was managed using percutaneous drainage and empirical antibiotics. Besides, renal tuberculosis was identified in the patient who did not respond to the treatment offered. A poor glycemic control may cause various fatal clinical complications. Concurrence of emphysematous pyelonephritis and iliopsoas abscess may be devastating for the patient that must be promptly managed to avoid any occurrence of septic shock. As the response to the treatment offered was inadequate, the coexistence of other disease states as renal tuberculosis was contemplated.
Keywords : emphysematous pyelonephritis, renal tuberculosis, iliopsoas abscess, COVID-19 pneumonia, diabetic ketoacidosis
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