Bilateral Xanthogranulomatous Pyelonephritis due to Staphylococcus Schleiferi: An Uncommon Presentation

Xanthogranulomatous pyelonephritis (XGP) describes a rare infectious disease with destructive granulomatous process. The literature contains few cases of bilateral XGP and no due to Staphylococcus schleiferi; we diagnosed it the advance at imaging bacterial identification systems technology. This is case 22-year-old female our emergency department complaining abdominal pain, nausea, emesis, dyspnea 3 weeks. Medical history included Chronic Kidney Disease (CKD) treated Peritoneal dialysis recurrent urinary tract infection. On examination, found signs septic shock suprapubic tenderness. No flank or renal mass on examination. Tomography (CT) scan showed kidney enlargement pyelocaliceal dilatation stones obstructing ureteral union; presence gas left kidney´s pelvis an abscess in posterior pararenal space. We Bilateral emphysematous pyelitis, initiated board-spectrum antibiotic perform urgent right nephrostomy nephrectomy. urinary, blood tissue culture identified pathogenic agents (Escherichia coli schleiferi) treatment was de-escalated. After two weeks treatment, she recovered acute chronic failure (ACRF) remaining 24ml/min/1.73m2 GFR (stage IV CKD) discharged from hospital.