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The AA. describe an unusual form of severe grahm negative bacterial infection of the renal parenchima that occurs infrequently in adult patients, most of whom are diabetics. During the acute phase, the kidney becomes smoothly enlarged, with marked impairment of contrast material excretion. The urographic and echographic findings simulated a renal neoplasm; on the contrary the selective renal angiography excluded the presence of a neoplastic blood circulation. This bacterial infection produces an inflammatory infiltrate surrounding and occluding the interlobular arteries in the cortex, with secondary ischemy. A precious and appropriate antibiotic therapy causes a rapid return of renal function; on the contrary this process may produce a globally small kidney in the long run.