RESUMEN
Emphysematous pyelonephritis [EPN] is a serious and often life threatening infection of the renal and perirenal tissues. The characteristic feature of this infection is the p resence of gas within the kidney and perinephric tissues. The triad of symptoms of fever; flank pain and pyuria especially in a diabetic patient who does not respond promptly to conventional antibiotic therapy must raise the possibility of EPN. CT Scan is the investigation of choice not only to establish the diagnosis but also to plan the line of management. Renal preservation must be the aim of management. This can be achieved to a great extent by aggressive antibiotic therapy in combination with percutaneous drainage of obstructed kidneys and abscesses. However nephrectomy is indicated in life threatening fulminant infection of the kidney. A case of EPN in a diabetic patient who was successfully managed by nephrectomy is presented. Review of literature and current concepts regarding the management of EPN are discussed