Stones, sugar and air-emphysematous pyelonephritis.
A 64-year-old man with known type 2 diabetes mellitus presented to the emergency department with high-grade fever (101°F), vomiting, right-sided flank pain and pyuria. Laboratory studies revealed total white blood cell count of 20 ×109/l, platelet count of 45 ×109/l and elevated serum creatinine (3.8 mg/dl). Numerous pus cells were seen …