title: Emphysematous Cystitis: A Rare Disease of Genito-Urinary System.
abstract: BACKGROUND
  Emphysematous cystitis (EC) is a rare infection of the urinary tract that results in gas production in the bladder. It is more common in diabetic and female patients, and can be associated with more serious complications, including pyelonephritis.
  
  
  METHODS
  We describe a case of recurrent bacterial cystitis caused by Escherichia coli (E. coli). An incidental finding in our patient of pneumaturia on computed tomography (CT) scan prompted further work-up. Differential diagnoses for pneumaturia include infection, trauma, and fistula, most commonly colovesicular. The patient history ruled out trauma and CT scanning ruled out a fistula; culture of the urine then showed a bacterial load greater than 100,000 E. coli/mL. The patient was then diagnosed with EC. She was treated with ceftriaxone and released in stable condition.
  
  
  CONCLUSIONS
  The literature was scarce when it came to diagnoses of EC based on bacterial load. We present this case to increase health care providers' awareness of recurrent EC with a urine culture bacterial load greater than 100,000 E. coli/mL.
authors.affiliation: Department of Internal Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, United States.
authors.forename: Shilpi
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Internal Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, United States.
authors.forename: Waqas
authors.initials: W
authors.lastname: Jehangir
authors.affiliation: Ross University School of Medicine, Portsmouth, Dominica.
authors.forename: Jay
authors.initials: J
authors.lastname: Littlefield
authors.affiliation: Ross University School of Medicine, Portsmouth, Dominica.
authors.forename: George
authors.initials: G
authors.lastname: Hanna
authors.affiliation: Ross University School of Medicine, Portsmouth, Dominica.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Bowling
authors.affiliation: Department of Internal Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, United States.
authors.forename: Abdalla
authors.initials: A
authors.lastname: Yousif
authors.affiliation: Department of Internal Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, United States.
authors.forename: John R
authors.initials: JR
authors.lastname: Middleton
keywords: Bacteriuria; Cystitis; Emphysematous cystitis (EC); Escherichia coli (E. coli); Pneumaturia; Pyelonephritis; Urine culture