Emphysematous cystitis: An atypical multi-organism presentation

Bos, Derek; Patal, Premal; DiTullio, Sonia

doi:10.5489/cuaj.1259

Cited by 6 publications

(7 citation statements)

References 10 publications

(15 reference statements)

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“…The spectrum of symptoms at presentation can range from patients being asymptomatic to a complicated course of illness, for example, sepsis and anuria [15][16][17]. Although abdominal pain and dysuria were relatively common presenting symptoms, altered mental status was observed in older individuals [5,6,10,11]. Rapid deterioration of patients was relatively uncommon unless the presenting symptoms and signs were suggestive of impending shock [6].…”

Section: Discussionmentioning

confidence: 99%

“Beyond the Bladder: Exploring the Intricacies of Emphysematous Cystitis and Its Surprising Associations”

Allena,

Javed,

Bojja

et al. 2023

Case Reports in Critical Care

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Emphysematous cystitis is defined by the presence of air within the bladder wall or lumen in imaging studies with increased incidence in elderly women and diabetics. It is a result of gas-forming organisms like Klebsiella and E. coli but can be caused by fungi such as Candida and Aspergillus as well with a wide spectrum of clinical presentations. In this article, we present a case of a 77-year-old female with diabetes mellitus who presented to the hospital with a chief complaint of left lower quadrant abdominal pain. Abdominal imaging revealed emphysematous cystitis, paraspinal abscess, and air in the thoracic and lumbar vertebrae. Laboratory results showed leukocytosis, lactic acidosis, and urinalysis significant for urinary tract infection but no positive urine or blood cultures. The patient was admitted to the intensive care unit for septic shock and was treated with mechanical ventilation, vasopressor support, and prompt antimicrobial therapy following which the requirement of vasopressors ceased on the third day of admission. The decision was then made by the family to pursue hospice care, following which mechanical ventilation was discontinued and the patient transferred to inpatient hospice. With this case report, we aim to add to the existing literature regarding the spread of intra-abdominal infections and go over a brief review of the currently available literature. From our review, we would like to conclude that the presence of pneumoracchis, especially in the setting of an intra-abdominal infection, is a poor prognostic marker, and timely diagnosis and treatment of potential causes are required to reduce mortality.

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Section: Discussionmentioning

confidence: 99%

“Beyond the Bladder: Exploring the Intricacies of Emphysematous Cystitis and Its Surprising Associations”

Allena,

Javed,

Bojja

et al. 2023

Case Reports in Critical Care

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“…En los años 80´s del siglo pasado, Eisenlohr describe el primer caso en autopsia (1). Más adelante, en 1961 Bailey et al realizan la primera serie clínica con 19 casos y le asignan el nombre de "cistitis enfisematosa" (3,5).…”

Section: Discussionunclassified

Retroneumoperitoneo secundario a cistitis enfisematosa

Morales-Cárdenas

Madrid²,

Fernández

et al. 2016

CES Med

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ResumenLa cistitis enfisematosa se define como la presencia de gas en la pared vesical secundaria a infección por microorganismos productores de gas. Es más frecuente en el género femenino, con predominio entre la sexta y octava década de la vida. Los factores de riesgo identificados son inmunosupresión, alteraciones estructurales o neurológicas del tracto urinario inferior, entre otros. Su prevalencia o incidencia es desconocida, dada la baja frecuencia de la enfermedad. Su forma de presentación clínica es muy variable e incluye desde un paciente asintomático hasta sepsis fulminante. El diagnóstico se puede realizar a través de estudios complementarios por imágenes o por métodos de visualización directa como la cistoscopia, laparotomía o laparoscopia, requiriendo rescate bacteriológico para confirmar la etiología infecciosa, siendo el método diagnóstico más usado la tomografía computarizada. Presentamos el caso de una paciente femenina con inmunosupresión cró-nica por esteroides a altas dosis como parte de manejo de lupus eritematoso sistémico retroneumoperitoneo y enfisema de tejidos blandos pélvi-cos secundario a cistitis enfisematosa por Klebsiella pneaumoniae. Se trata del primer caso reportado de retroneumoperitoneo secundario a cistitis enfisematosa en una paciente con lupus eritematoso sistémico cuyo único factor de riesgo identificado fue la inmunosupresión farmacológica con esteroides.Palabras clave: Cistitis enfisematosa, Infección del tracto urinario, Tomografía computada multidetector, Lupus eritematoso sistémico, Retroneumoperitoneo. AbstractEmphysematous cystitis is defined as the presence of gas in the bladder wall due to infection by gas-forming organisms. It is more common in females, predominantly between the sixth and eighth decades of life. The identified risk factors are immunosuppression (secondary to systemic diseases or drugs); structural or neurological lower urinary tract alterations,

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“…Ec is relatively rare condition, with 237 cases were reported till 2013. Gas in the urinary tract was described in 1961 and defined by Baily in 1971 as EC (Bos D. et al, 2014). Ec is potentially fatal, as it results in a necrotizing infection that begins in the bladder and ascends to the renal parenchyma.…”

Section: Discussionmentioning

confidence: 99%

Long Standing Emphysematous Cystitis Ends with Chronic Renal Failure and High Intravesical Pressure (Short Communication)

Mustafa¹

2016

An-Najah University Journal for Research - A

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A 61-year old male patient with end stage renal failure and severe bilateral hydronephrosis was admitted to our hospital. The patient had pneumaturia since many years with history of several surgeries due to urethral strictures. Computed tomography showed air fluid level in the bladder and bilateral hydronephrosis with air bubbles in the kidneys. Urodynamic study revealed normal bladder volume with increased intravesical pressure during the filling phase. Urine culture was positive for klebsiella pneumonia. Prompt reduction in the serum creatinine level was observed after appropriate medical therapy and catheterization of the bladder. Emphysematous cystitis although it can be managed easily, it may lead to impairment of renal function if no appropriate management was given. مريض ذكر بعمر 61 سنة حضر الى مستشفانا بفشل كلوي مع وجود انتفاخ حاد في حوض الكليتين. يعاني المريض من وجود هواء في البول منذ عدة سنوات واجري له العديد من العمليات بسبب تضيق في مجرى البول (الاحليل). اتضح بالصورة الطبقية وجود مستوى هواء و سائل في المثانة مع وجود انتفاخ وفقاعات هواء في كلا الكليتين. اجري له تخطيط مثانة وتبين أن حجم المثانة طبيعي مع زيادة في ضغط المثانة خلال فترة التعبئة. بعد زراعة البول تبين ان البول يحتوي على klebsiella pneumonia. كان هناك تحسن ملحوظ بوظائف الكلية بعد اعطاء العلاج المناسب ووضع قسطرة للمثانة. بالرغم من أن التهاب المثانة الهوائي يعالج بسهولة إلا أنه قد يؤدي الى خلل حاد في وظائف الكلية اذا لم يتم اعطاء العلاج المناسب له.

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Emphysematous cystitis: An atypical multi-organism presentation

Cited by 6 publications

References 10 publications

“Beyond the Bladder: Exploring the Intricacies of Emphysematous Cystitis and Its Surprising Associations”

“Beyond the Bladder: Exploring the Intricacies of Emphysematous Cystitis and Its Surprising Associations”

Retroneumoperitoneo secundario a cistitis enfisematosa

Long Standing Emphysematous Cystitis Ends with Chronic Renal Failure and High Intravesical Pressure (Short Communication)

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