Salmonella emphysematous pyelonephritis in a nondiabetic and non-obstructive end-stage renal disease patient

Emphysematous pyelonephritis (EPN) is a rare, severe, and gas-forming infection of the kidney. EPN is common in patients with diabetes mellitus and/or urinary tract obstruction. EPN rarely occurs in patients with end-stage renal disease, and is rarely caused by non-typhoidal Salmonella. This is a case report of end-stage renal disease in a 28-year-old woman who refused regular hemodialysis. She presented with fever, abdominal pain and right flank pain. Unenhanced computed tomography showed air within the right kidney. Salmonella group D was isolated from the drainage. The patient was successfully treated with antibiotics and percutaneous catheter drainage. To our knowledge, this is the first case report in the literature of EPN caused by Salmonella in a patient with end-stage renal disease who did not have diabetes mellitus or urinary tract obstruction.