Emphysematous pyelonephritis with an unusual cause

Emphysematous pyelonephritis is a severe infection that occurs in both diabetic and nondiabetic persons who have ureteral obstruction. A high index of suspicion and an aggressive workup are essential for the diagnosis. Management-medical therapy with or without surgical intervention-is based on clinical, laboratory, and CT findings. We present a case of emphysematous pyelonephritis associated with lactobacillemia and Candida glabrata and Candida albicans fungemia in a diabetic patient with bilateral ureteral stents. To the best of our knowledge, this is the second case of emphysematous pyelonephritis associated with lactobacillemia reported in the literature.