Clinical Practice and Cases in Emergency Medicine

Emphysematous pyelonephritis (EPN) is a rare, life-threatening infection, and misdiagnosis asuncomplicated pyelonephritis is potentially fatal. Point-of-care ultrasound (POCUS) is a valuable toolfor evaluation of the kidneys in patients with septic shock and pyelonephritis. While used primarilyto assess for the complication of obstruction and hydronephrosis, POCUS may also detect signs ofEPN and prompt surgical consultation for nephrectomy. We present a case in which the emergencyphysician diagnosed EPN by POCUS in a patient with septic shock and pyelonephritis.