Emphysematous Cystitis - A rare cause for urosepsis

Abstract

An 89 year old female with diabetes mellitus, dyslipidemia, hypertension and ischemic heart disease admitted to orthopedic department following intra-capsular neck of femur fracture. While awaiting Austin Moore Hemiarthroplasty (AMH), she developed lower abdominal pain, fever, features of acute cystitis, hematuria and pneumaturia. Her urine culture was positive for Escherichia coli (E. coli) and blood culture for gram negative bacilli. Further evaluation with abdominal X-ray (Figure 1) and computed tomography (CT) (Figure 2) showed evidence of emphysematous cystitis (EC). Her urosepsis was treated with intravenous (IV) Meropenem 500mg eight hourly for 14 days. She recovered from sepsis and subsequently underwent AMH.