Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 9 3 2020 07 01 Successful non-surgical management of bilateral emphysematous pyelonephritis despite adverse prognostic factors; report of a case and review of the literature e29 e29 10.34172/jnp.2020.29 EN Seyed Reza Yahyazadeh https://orcid.org/0000-0001-7072-3149 Tayebeh Soleymanian https://orcid.org/0000-0002-1959-5038 Journal Article 10.34172/jnp.2020.29 2018 08 15 2019 11 06 Emphysematous pyelonephritis (EPN) is a rare and ominous necrotizing kidney infection mainly involving diabetic patients. While prompt medical therapy with antibiotic and percutaneous catheter drainage is mainstay of management, nephrectomy should remain for unresponsiveness situations with poor prognostic factors. We introduced the clinical course of an old male presented with bilateral EPN which was successfully treated without nephrectomy regardless of various risk factors such as thrombocytopenia, impaired consciousness, and acute renal failure.