Case 54
Clinical Presentation
A 58-year-old man who has diabetes presents with fever and backache.
Imaging Findings
Noncontrast computed tomography (CT) image at the level of the kidneys shows that the left kidney (asterisk) is small, with a large amount of air in the renal parenchyma and under the capsule (arrow). Left perinephric stranding is present (arrowheads). Minimal stranding and fluid are also seen around the right kidney.
Differential Diagnosis
• Emphysematous pyelonephritis: Air in the renal parenchyma and collecting system is characteristic. The history of diabetes supports the diagnosis.
• Renal abscess:
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