Case 153. 
E. coli-induced emphysematous pyelonephritis (64 y-o M)
    Autopsied kidneys of a patient of alcoholic cirrhosis, manifesting lethal septic shock (clinical course: 9 days)    
Key words : 
E. coli, emphysematous pyelonephritis, non-clostridial gas gangrene    
opportunistic infection
The both kidneys are enlarged and multifocal gangrenous changes with gas formation (gross findings). Foul smelling is not associated.   Gas formation is evident in the necrotic renal parenchyma, in association with marked neutrophilic infiltation (HE, low power).
Numerous Gram-negative rods are clustered within the necrotic renal tubules and around gas-filled bubbles (HE, high power). Microbial culture confirmed the infection of E. coli. This condition is called non-clostridial gas gangrene.