Introduction: Emphysematous pyelonephritis (EPN) is a severe, necrotizing renal parenchymal infection that is characterized by the production of intraparenchymal gas. One gaseous component, carbon dioxide, is generated by bacterial fermentation of glucose. Patients with EPN show relatively vague symptoms initially, but frequently undergo a sudden deterioration in their condition, necessitating urgent medical attention. Treatment of patients with EPN comprises resuscitation, correction of any electrolyte and glucose problems, and administration of antibiotics targeting Gram-negative bacteria. Urinary tract obstruction is relieved by a percutaneous nephrostomy or stent. Definitive management is by percutaneous drainage, except when there is extensive diffuse gas with renal destruction; in this case, a nephrectomy is advised. Patients and method: one cases series study was performed at Cho Ray hospital from May 2011 to May 2013. Results: Between May 2011 and May 2013, nine cases of EPN was diagnosed and treated at the department of Urology, two male and seven female. 8/9 cases are diabetics. 3/9 cases has the prehistory of urinary litthiasis. Four cases of EPN grouped 3b on diabetic patients that has severe complications of septic shock, acute renal failure, pneumonia and coagulation, 4 cases of 3a and 1 case of stage 2. One patient died of multiple organ failure. Conclusion: Although rare, EPN carries major morbidity and significant mortality. Prompt diagnosis and appropriate aggressive treatment is likely toreduce mortality.
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