title: [Emphysematous cystitis: report of one case].
abstract: We report a 53 year-old woman with type 2 diabetes mellitus and hypertension, presenting with progressive abdominal pain lasting three weeks, associated with lower abdominal swelling and fever. Clinical examination showed a large increase in abdominal volume, contraction of extracellular compartment, and signs of severe sepsis. Computed tomography showed an over-distended bladder with severe wall and luminal pneumatosis and bilateral hydronephrosis. The diagnosis was of emphysematous cystitis associated to hydronephrosis. Urine and blood cultures were positive for multi-susceptible Escherichia coli. Clinical evolution was favorable after 6 weeks of ceftriaxone and urinary catheter use. Emphysematous cystitis is a rare clinical entity, with an associated mortality of 7%. Known predisposing factors are older age, female gender and presence of diabetes. Microbiological agents most frequently involved are Escherichia coli and Klebsiella pneumoniae (80% of cases). Medical treatment is preferred and is based on urinary tract decompression with a bladder catheter, and prolonged broad spectrum antimicrobial therapy.
authors.forename: Edith Pérez de Arce
authors.initials: EP
authors.lastname: Oñate
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Sanhueza
authors.forename: Rubén
authors.initials: R
authors.lastname: Torres
authors.forename: Erico
authors.initials: E
authors.lastname: Segovia
mesh_terms: D003556:Cystitis / Q000175:diagnosis* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004646:Emphysema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D014057:Tomography, X-Ray Computed