Concurrent emphysematous pyelonephritis and emphysematous cholecystitis due to community-acquired ESBL E. coli

Description  

A 62-year-old man with a history of hypertension and poorly controlled type II diabetes mellitus presented to his primary care physician with a 5-day history of chills, decreased urinary output and haematuria. Urinalysis was consistent with urinary tract infection and the patient was prescribed ciprofloxacin. He did not take the antibiotics as instructed and subsequently had to come to Emergency Room due to worsening of his condition as well as new complaints of increased thirst, dark urine and lower back pain. He also admitted that for the previous 3 days he had not been taken insulin due to his illness. On examination, he was an obese man in no distress, fully alert and oriented. The temperature was 97^oF, the blood pressure 125/58 mm Hg, the pulse 112 beats/min, the respiratory rate 16 breaths/min and the oxygen saturation 93% on ambient air. Abnormal findings included scleral icterus, mild jaundice, tachycardia, right...

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