Complicated case of bilateral emphysematous pyelonephritis and emphysematous cystitis successfully treated with transurethral drainage and ureteral stents

Emphysematous pyelonephritis and emphysematous cystitis are intractable diseases. Eight cases of bilateral emphysematous pyelonephritis and emphysematous cystitis have been reported, but no treatment has been established. An 88-year-old female was admitted with traumatic subarachnoid hemorrhage, and on the fourth day of hospitalization, she developed fever and septic shock. A computed tomography scan revealed bilateral emphysematous pyelonephritis and emphysematous cystitis. The patient was treated with bilateral double-J stents and an indwelling urethral catheter. This is the first report of bilateral emphysematous pyelonephritis and emphysematous cystitis treated conservatively with drainage and an internal stent, which may be a treatment option.