PMC9723515_01
A simple computed tomography scan reveals air extending to the left perirenal region (arrow).
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C-reactive protein level was 26.56 mg/dL. Computed tomography (CT) showed extensive air in the perirenal space, and a diagnosis of class 3A emphysematous pyelonephritis was determined (Fig. 1).
Soft shadows around the lower lumbar vertebrae were observed, and osteolytic changes in the vertebral endplates appeared, leading to a diagnosis of pyogenic spondylitis.
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Although blood sample data showed improvement, the patient complained of back pain, and on day 39 after admission, a CT scan revealed a new complication of pyogenic spondylitis at L4/5 (Fig. 2).
The graph shows a clinical progress chart.. Changes in antibiotics, treatments, and data such as CRP and WBC are shown.
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The patient was started on cefazolin 750 mg/day alone on day 97 after admission and was discharged for continued rehabilitation 118 days after admission (Fig. 3).