Emphysematous Cystitis Following Bone Marrow Transplant

Emphysematous cystitis is an exceedingly rare complication of urinary tract infection in children and adults. Characterized by air within the bladder wall, this life-threatening condition most often impacts diabetic women. The inciting pathogen is typically Escherichia coli or Klebsiella pneumoniae, though many other organisms have also been reported. Diagnosis is most commonly made via computed tomography scan; however, plain radiographs have also been described to be diagnostic. Medical management is the mainstay of therapy, consisting of bladder decompression and treatment of the underlying infection. Urologic surgery is required in 10% of cases. We report a 10-year-old child with a recent history of bone marrow transplantation complicated by gut-associated graft-versus-host disease who was diagnosed with emphysematous cystitis following a change in his abdominal pain.