title: Emphysematous cystitis due to recurrent Clostridium difficile infection.
abstract: A 78-year-old woman with long-standing obstipation presented herself to the hospital with diarrhoea and progressive abdominal cramping since 2 days. Acute abdomen developed and an emergency exploratory laparotomy was indicated, which showed no signs of bowel ischaemia. After admission to the internal ward, stool Clostridium difficile PCR was tested positive. Hence the diagnosis of pseudomembranous colitis became apparent. Abdominal imaging demonstrated multiple gas foci in the wall of the bladder and extensive pseudomembranous colitis. The patient was initially treated with oral vancomycin and secondarily with metronidazole for recurrent C. difficile infection. Resolution of diarrhoea and abdominal cramping was noted on 6-week follow-up visit.
authors.affiliation: Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands.
authors.forename: Michel E
authors.initials: ME
authors.lastname: van Genderen
authors.affiliation: Department of Radiology, Ikazia Hospital, Rotterdam, The Netherlands.
authors.forename: Jeroen G J
authors.initials: JG
authors.lastname: Jonkman
authors.affiliation: Department of Microbiology, Ikazia Hospital, Rotterdam, The Netherlands.
authors.forename: Michiel
authors.initials: M
authors.lastname: van Rijn
authors.affiliation: Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Dees
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D003556:Cystitis / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D004646:Emphysema / Q000209:etiology; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology*; D005260:Female; D006801:Humans; D059413:Intraabdominal Infections / Q000188:drug therapy / Q000382:microbiology; D008795:Metronidazole / Q000627:therapeutic use; D012008:Recurrence; D001743:Urinary Bladder / Q000382:microbiology* / Q000473:pathology; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole; D014640:Vancomycin