Emphysematous Cystitis in an Immunocompromised Patient With Ovarian Cancer: A Case Report

Emphysematous cystitis (EC) is a rare, potentially life-threatening infection characterized by gas formation within the bladder wall or lumen, most commonly caused by Escherichia coli or Klebsiella pneumoniae. It is typically associated with diabetes mellitus, immunosuppression, or urinary tract abnormalities. We present a case of EC in a 67-year-old immunocompromised female with advanced-stage ovarian cancer, undergoing chemotherapy with carboplatin and paclitaxel at the time of diagnosis. Her additional risk factors included diabetes mellitus and chronic corticosteroid use. Diagnosis was established via CT angiography, which revealed extensive gas within the bladder wall. Urine culture grew Klebsiella pneumoniae sensitive to ceftriaxone, which was administered intravenously. The patient was managed conservatively with antibiotics, bladder decompression, and supportive care, resulting in resolution of the infection. To our knowledge, this is the first reported case of EC in a patient receiving carboplatin and paclitaxel chemotherapy for ovarian cancer, underscoring the diagnostic complexity and management considerations of EC in oncology patients with compounding immunosuppressive risk factors.