[Emphysematous cystitis: case report].
OBJECTIVE
To report one case of emphysematous cystitis and to review its diagnosis and treatment in the related literature.


METHODS
We report the case of a type II diabetic 91-year-old woman with jaundice, hematuria, vomits, abdominal pain and poor glycemia control. Diagnosis was obtained by plain abdominal X-ray and ultrasonography, and confirmed by CT. E.coli was isolated in urinary culture.


RESULTS
Antibiotic intravenous therapy with piperacillin-tazo-bactam, urinary bladder catheterization and strict glycemia control. The patient was discharged from hospital on day 5, with 14 additional days of orally administered amoxicillin-clavulanic and bladder catheterization. Complete clinical, radiologic and microbiologic resolution was achieved.


CONCLUSIONS
Emphysematous cystitis is a rare entity, most common in diabetic women, which results from infection of the urinary bladder with gas-producing pathogens, mainly E.coli. Clinical presentation is variable. Emphysematous cystitis can be diagnosed radiologically, mainly with CT scan. The management consists of broad-spectrum antibiotics, strict glycemic control and bladder drainage. Emphysematous cystitis usually has a benign course, but complications may arise in up to 10-20% of cases, requiring surgical treatment.
Pérez Fentes
Daniel
D
Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España. danielfentes@yahoo.es
Blanco Parra
Miguel
M
Lema Grille
José
J
Toucedo Caamaño
Valentín
V
Novás Castro
Serafín
S
Lamas Cedrón
Pedro
P
Villar Núñez
Manuel
M
D000369:Aged, 80 and over; D003556:Cystitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D004646:Emphysema / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans