男性,64岁,诉背痛、发热、寒战、呼吸困难1周,直肠体温38℃,脉率120次/分,呼吸30次/分,两肺底部叩诊浊音,右腰部触痛,血白细胞19,900/立方毫米,血糖319毫克%,尿素氮88毫克%,尿糖(+),尿白细胞70～100/高倍和大量杆菌,血和尿培养大肠杆菌生长。胸片显示双侧胸腔积液,两肺下叶浸润。腹部平片见右肾及肾周围积气、胃扩张。排泄性尿路造影右肾无功能和膀胱壁积气,诊断为气肿性肾盂肾炎合并肾周围脓肿,气肿性膀胱炎。抗菌治疗1周后,行右肾周围大脓肿切开排脓及右肾切除术,脓肿和肾的脓液培养为大肠杆菌,术后病情不断恶化而死 Male, 64 years old, complaining of back pain, fever, chills, dyspnea for 1 week, rectal temperature 38 ℃, pulse rate 120 beats / min, breathing 30 beats / min, / Cubic millimeter, blood glucose 319 mg%, urea nitrogen 88 mg%, urine sugar (+), urinary white blood cells 70 to 100 / high and a large number of bacteria, blood and urine culture Escherichia coli growth. Chest radiograph showed bilateral pleural effusion, infiltration of the lower lungs. Abdominal plain film see the right kidney and kidney around the gas, stomach dilatation. Excretory urography right kidney without bladder function and gas, diagnosed as emphysematous pyelonephritis with renal abscess, emphysematous cystitis. After 1 week of antimicrobial treatment, abscesses of the right abscess around the right kidney were dissected and the right nephrectomy was performed. The abscesses of the abscess and kidney were cultured as E. coli, and their condition deteriorated after the operation