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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Pneumaturia or the passage of air in urine is an uncommon but clinically significant presenting complaint. It can occur in patients having abnormal communication between gut and genitourinary tract. In diabetic patients, it is a particular indicator of emphysematous pyelonephritis (EPN), a severe, necrotizing infection of the renal parenchyma associated with high morbidity and mortality. Early recognition and timely management are crucial.
We present a series of five diabetic patients who presented with pneumaturia and were subsequently diagnosed with EPN. Demographic and clinical data, including age, sex, duration of diabetes, presenting complaints, examination findings, glycemic status (HbA1c), urine culture and sensitivity (CS) reports, computed tomography (CT) classification of EPN (Huang and Tseng), management and outcomes were recorded and analyzed.
The mean age of the patients was 52.6 ± 2 years and all were post-menopausal women. All five (100%) patients had pneumatura. Fever (4/5, 80%) and flank pain (4/5, 80%) were common presenting complaints. Other complaints were altered sensorium (2/5, 40%) and hypotension (1/5, 20%). Costovertebral angle tenderness was detected in 3 (60%) cases. All had type 2 diabetes mellitus of 7–25 years duration with poor glycemic control (mean HbA1c 13.1 ± 2%). Acute kidney injury was documented in three (60%) patients and all of them improved with medical management and none required dialysis. Urine culture grew Escherichia coli in three patients and all were sensitive to carbapenems and aminoglycosides and urine was sterile in remaining two patients. Blood culture revealed growth of E. coli in one patient. CT classification showed class 2 EPN in four patients and class 3B in one patient who also had hydroureteronephrosis (HUN) and a suspected bladder neoplasm. All patients were treated conservatively with broad-spectrum intravenous antibiotics, intravenous fluid and optimization of glycemic control. One patient with class 3B disease with suspected neoplasm and HUN was referred to urology and lost to follow-up. Remaining four patients recovered completely.
Pneumaturia, though rare, is an important presenting feature of EPN in diabetic patients. Recognizing this clue can lead to early imaging and targeted management, significantly improve patient outcomes. Clinicians should maintain a high index of suspicion for EPN in diabetic patients presenting with pneumaturia.
