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Emphysematous cystitis
C Perlemoine1, D Neau, J M Ragnaud
1Service de Diabétologie-Nutrition, Hôpital Haut-Lévêque, Avenue Magellan, Pessac, France. caroline.perlemoine@chu-bordeaux.fr
Diabetes & Metabolism
|November 5, 2004
Summary
Emphysematous cystitis, a urinary tract infection complication, occurred in a diabetic patient with poor glycemic control. Early diagnosis via abdominal X-ray is crucial for severely ill patients with urinary tract infections.
Area of Science:
- Urology
- Infectious Diseases
- Endocrinology
Background:
- Emphysematous cystitis is a rare urinary tract infection complication.
- Diabetic patients with poor glycemic control are at higher risk.
- Alcoholic chronic pancreatitis can be a contributing comorbidity.
Observation:
- A 62-year-old woman presented with confusion and vomiting, found to be undernourished and agitated with hepatomegaly.
- Urinalysis revealed significant leukocytes and Escherichia coli growth.
- Abdominal plain film and CT scan confirmed gas within the urinary bladder wall.
Findings:
- The patient was diagnosed with emphysematous cystitis.
- Treatment included Foley catheterization, antibiotics, insulin, rehydration, vitamin supplementation, and pancreatic enzyme replacement.
- The condition is often diagnosed incidentally on imaging due to nonspecific symptoms.
Implications:
- A high index of suspicion is necessary for early diagnosis of emphysematous cystitis.
- Abdominal X-ray is recommended as a screening tool for severely ill diabetic patients with UTIs.
- Prompt diagnosis and treatment are essential for improving patient outcomes.