Abstract

PEREZ FENTES, Daniel et al. Emphysematous cystitis: Case report. Arch. Esp. Urol. [online]. 2009, vol.62, n.5, pp.392-395. ISSN 0004-0614.

Objective: To report one case of emphysematous cystitis and to review its diagnosis and treatment in the related literature. Method: We report the case of a type II diabetic 91-year-old woman with jaundice, hematuria, vomits, abdominal pain and poor glycemia control. Diagnosis was obtained by plain abdominal X-ray and ultrasonography, and confirmed by CT. E.coli was isolated in urinary culture. Results: Antibiotic intravenous therapy with piperacillin-tazobactam, urinary bladder catheterization and strict glycemia control. The patient was discharged from hospital on day 5, with 14 additional days of orally administered amoxicillinclavulanic and bladder catheterization. Complete clinical, radiologic and microbiologic resolution was achieved. Conclusions: Emphysematous cystitis is a rare entity, most common in diabetic women, which results from infection of the urinary bladder with gas-producing pathogens, mainly E.coli. Clinical presentation is variable. Emphysematous cystitis can be diagnosed radiologically, mainly with CT scan. The management consists of broad-spectrum antibiotics, strict glycemic control and bladder drainage. Emphysematous cystitis usually has a benign course, but complications may arise in up to 10-20% of cases, requiring surgical treatment.

Keywords : Emphysematous cystitis; Diagnosis; Treatment.

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