What is the most common offending agent in emphysematous pyelonephritis?

Emphysematous pyelonephritis is a severe and potentially life-threatening infection of the kidney characterized by the presence of gas in the renal parenchyma. The most common offending agent in this condition is Escherichia coli (E. coli), a gram-negative bacterium. This organism is often associated with urinary tract infections and has a propensity to cause more severe infections, especially in patients with underlying diabetes mellitus or urinary tract obstruction, which are common risk factors for developing emphysematous pyelonephritis.

E. coli’s ability to produce gas-forming agents, such as carbon dioxide, contributes to the characteristic radiological findings of gas accumulation within the renal tissue. This makes E. coli the primary bacterial agent to look for in cases of emphysematous pyelonephritis, influencing both diagnosis and treatment approaches in affected patients.