Emphysematous pyelonephritis caused by Pasteurella multocida

Emphysematous pyelonephritis (EPN) is an acute, life-threatening, necrotizing infection of the kidney. It is most often seen in diabetic patients with poor glucose control and urinary obstruction, and it also is seen in patients who have structural kidney disease. Although surgical intervention is the mainstay of therapy, percutaneous drainage may have a role in surgical patients who are at high risk. We present an uncommon case of EPN associated with Pasteurella multocida infection following embolization of a large renal tumor in a nondiabetic patient. Clinicians and radiologists should maintain a high index of suspicion in patients with structural kidney disease who present with acute or subacute symptoms.