Emphysematous Cystitis: An unusual disease of the bladder diagnosed on imaging

Case report


Sataa Sallami, Sami Ben Rhouma, Ali Horchani

Department of Urology, La rabta Hospital, Tunis, Tunisia

IJMBS 2009;1(1):20-24


Emphysematous cystitis (EC) is defined by the presence of gas in the urinary bladder wall. This rare disease entity is caused by gas fermenting bacterial and fungal pathogens. It complicates urinary tract infections especially in diabetic patients but other disabling general medical conditions may be present. Because the clinical symptoms are nonspecific, the diagnosis is often made incidentally on X-rays. Early diagnosis and treatment improve the outcome.
We report a case of 83-year-old diabetic female who presented with fever, dysuria and gross hematuria. Ultrasonography and computed tomography revealed gas accumulation in the wall and lumen of the bladder leading to the diagnosis of emphysematous cystitis. She was treated with antibiotics, insulin, rehydratation and a Foley catheter placement. Diabetic patients with urinary tract infections who are severely ill should have radiological investigations to rule out the prsence of emphysematous complications.

Keywords: Emphysematous cystitis – Diabetes mellitus – Urinary tract infections – Klebsiella pneumoniae.

Link/DOI: http://journals.sfu.ca/ijmbs/index.php/ijmbs/article/view/14/57