[A 61-year-old woman with abdominal pain and urination disorders].
The case of a 61 yo diabetic woman presenting with dysuria and lower abdominal pain is described. The incomplete resolution of the clinical picture after short antibiotic treatment and a strong suspect of autonomic neuropathy oriented to an anamnestic reevaluation that evidenced the presence of pneumaturia. The last was the key-symptom that guided to diagnostic imaging showing emphysematous cystitis while a gastroscopy confirmed the presence of autonomic neuropathy manifested by gastroparesis. Emphisematous cystitis is a characteristic infectious complication of diabetic patients induced by a persistent incomplete bladder emptying and bacterial glucose fermentation. The complete eradication of the infectious agent requires a long term antibiotic course and a prompt identification of this pathology.
Picardi
A
A
Manfrini
S
S
Navajas
F
F
De Iorio
F
F
Amicarelli
E
E
Spoto
S
S
Meloni
M C
MC
De Galasso
L
L
Vespasiani Gentilucci
U
U
Scarlata
S
S
Costantino
S
S
D015746:Abdominal Pain / Q000209:etiology; D003556:Cystitis / Q000175:diagnosis* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis*; D003928:Diabetic Nephropathies / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D014555:Urination Disorders / Q000209:etiology