title: Emphysematous cystitis following a transrectal needle guided biopsy of the prostate.
abstract: BACKGROUND
  Emphysematous cystitis (EC) is a comparatively rare urinary tract infection characterized by air within the bladder wall and lumen and is usually associated with immunosuppression or poorly controlled diabetes mellitus.
  
  
  METHODS
  We report a case of EC in a 70-year-old man who recently underwent transrectal ultrasound needle-guided prostate biopsy, after which he underwent pylorogastrectomy. He did not have any history of diabetes mellitus or any immunosuppressive disease. The patient developed severe sepsis, requiring intravenous antibiotics and urinary catheterization. Despite therapy, the patient developed disseminated intravascular coagulopathy and acute respiratory distress syndrome. Therefore, he was admitted to the intensive care unit, antibiotic coverage was broadened, and danaparoid sodium and sivelestat sodium hydrate was administered. After 20 days, the patient's condition improved, and on the 28th day, the patient was discharged to home in a good condition without any sequelae.
  
  
  CONCLUSIONS
  Prompt diagnosis and treatment are warranted to prevent potential morbidity of and mortality in cases of EC.
authors.affiliation: Department of Urology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Kazunori
authors.initials: K
authors.lastname: Namiki
authors.forename: Ayako
authors.initials: A
authors.lastname: Tanaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimodaira
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Gondo
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tachibana
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D055499:Catheter-Related Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D003556:Cystitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000188:drug therapy; D005743:Gastrectomy; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000175:diagnosis; D016896:Treatment Outcome; D062885:Urinary Catheters / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents