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Urinary Tract Infection II: Pathophysiology

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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...

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Related Experiment Video

Updated: May 15, 2026

Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice

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Enterococcus faecium related emphysematous cystitis and bladder rupture.

Stalin Viswanathan¹, Rangarajan Pakshi Rajan, Nayyar Iqbal

¹Indira Gandhi Medical College, Pondicherry.

The Australasian Medical Journal

|January 5, 2013

Summary

This summary is machine-generated.

A severe urinary tract infection led to bladder gangrene and rupture after vacuum-assisted delivery. This rare case highlights Enterococcus faecium complications and the need for extensive surgical intervention.

Keywords:

Emphysematous cystitis bladder rupture gangrenous cystitis

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Area of Science:

Urology
Infectious Diseases
Surgical Case Report

Background:

Urinary tract infections (UTIs) are common postpartum complications.
Vacuum-assisted delivery can increase the risk of obstetric trauma and subsequent infections.
Emphysematous cystitis is a rare, severe UTI characterized by gas in the bladder wall.

Observation:

A 32-year-old woman presented with UTI symptoms post-vacuum-assisted delivery.
Clinical presentation included signs of severe bladder compromise: gangrene and rupture.
Diagnosis confirmed Enterococcus faecium as the causative agent of emphysematous cystitis.

Findings:

The patient required emergency laparotomy and partial cystectomy due to bladder rupture.
Persistent bladder necrosis necessitated a repeat laparotomy.
Prolonged hospitalization (over two months) was complicated by hospital-acquired pneumonia, adult respiratory distress syndrome, and malnutrition.

Implications:

This case underscores the potential for severe, life-threatening complications from UTIs, even in young patients.
Enterococcus faecium can cause aggressive infections leading to significant morbidity.
Management requires multidisciplinary care, including extensive surgical intervention and critical care support.