[Emphysematous cystitis: report of one case].

Area of Science:

• Urology
• Infectious Diseases
• Radiology

Background:

• Emphysematous cystitis is a rare, life-threatening bladder infection characterized by gas in the bladder wall.
• Predisposing factors include diabetes mellitus, older age, and female gender.
• Escherichia coli and Klebsiella pneumoniae are the most common causative agents.

Observation:

• A 53-year-old woman with type 2 diabetes and hypertension presented with abdominal pain, swelling, and fever.
• Computed tomography revealed an over-distended bladder with pneumatosis and bilateral hydronephrosis.
• Clinical examination indicated severe sepsis and extracellular compartment contraction.

Findings:

• The patient was diagnosed with emphysematous cystitis associated with hydronephrosis.
• Blood and urine cultures identified multi-susceptible Escherichia coli.
• Treatment involved ceftriaxone and urinary catheterization.

Implications:

• Emphysematous cystitis has a 7% mortality rate, underscoring the need for prompt diagnosis and management.
• Medical management, including urinary decompression and antibiotics, is the preferred treatment approach.
• This case highlights the importance of considering emphysematous cystitis in diabetic patients with sepsis symptoms.