A 55 year old woman known to have diabetes, presented with complaints of acute onset, high grade fever with chills, burning micturition and right flank pain since three days. Her total leukocyte count was 29,000.
Non contrast CT scan of the abdomen show an enlarged right kidney with perinephric fat stranding with thickening of anterior and posterior renal fascia. There is mild right hydronephrosis with dilatation of the proximal ureter. There are multiple air foci in renal pelvis and proximal ureter.