Emphysematous cystitis due to
            <i>Klebsiella pneumoniae</i>

Ahmed, Nisar; Sabir, Sohail; Khan, Nasiruddin

doi:10.5144/0256-4947.2008.50

Cited by 6 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CT scan is considered the diagnostic modality of choice for EC. A CT scan not only delineates the extent of the disease, whether the infection has spread beyond the bladder to involve the pelvicalyceal systems and renal parenchyma, but is also helpful in detecting any associated air and/or fluid in the peritoneal cavity [ 16 , 14 ], as was demonstrated in our case. The source of the pneumoperitoneum has been attributed to the rupture of intramural blebs in patients with EC, causing tracking of air into the peritoneum without true transmural perforation [ 15 ].…”

Section: Discussionmentioning

confidence: 94%

A Case of Concomitant Emphysematous Cystitis and Clostridium difficile Colitis with Pneumoperitoneum

Tariq

Farishta

Rizvi

et al. 2018

Cureus

View full text Add to dashboard Cite

Emphysematous cystitis (EC) is a rare condition described as air within the wall and lumen of the urinary bladder. It is a complicated form of urinary tract infection caused by gas-forming bacteria. Pneumoperitoneum described as gas in the peritoneum is usually seen with abdominal hollow organ perforation, and approximately 10% of cases have been reported that are not associated with abdominal hollow viscus perforation. To the best of our knowledge, no case of EC with pneumoperitoneum in the setting of concurrent Klebsiella urinary tract infection and Clostridium difficile (C. difficile) colitis have been reported. Here we present a unique case of EC with pneumoperitoneum, in a patient with recurrent C. difficile infection and Klebsiella pneumonia-urinary tract infection, treated conservatively with a favorable outcome.

show abstract

Section: Discussionmentioning

confidence: 94%

A Case of Concomitant Emphysematous Cystitis and Clostridium difficile Colitis with Pneumoperitoneum

Tariq

Farishta

Rizvi

et al. 2018

Cureus

View full text Add to dashboard Cite

show abstract

“…The spectrum of symptoms at presentation can range from patients being asymptomatic to a complicated course of illness, for example, sepsis and anuria [ 15 – 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

View full text Add to dashboard Cite

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.

show abstract

“…CT scan is considered the ideal diagnostic modality for EC. This can characterize the extent of the disease beyond the bladder into the pelvicalyceal systems and renal parenchyma [ 13 , 14 ]. Since colovesical fistula is a known complication of Crohn’s colitis [ 15 ] we completed a comprehensive workup to rule out any fistulating disease.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous cystitis as a potential marker of severe Crohn's disease

Hasan

Salh

2022

BMC Gastroenterol

View full text Add to dashboard Cite

Background Emphysematous cystitis (EC) is characterized by the presence of air within the bladder wall, often a complication of urinary tract infection (UTI) by gas-producing organisms. However, EC has also been reported in the setting of infectious colitis suggesting an alternate etiology. We report a rare case of EC in the setting of severe Crohn’s colitis with no clinical evidence of UTI. Case presentation A 43-year old female presented with a 2-month history of bloody diarrhea consisting of 8–12 bowel movements a day, weight loss of 10 kg and peripheral edema. She also had multiple ulcerated lesions on her abdominal wall and in the perianal region. Initial CT scan was significant for pancolitis, anasarca and EC. The follow-up CT cystogram, flexible cystoscopy and pelvic MRI confirmed the diagnosis of EC and ruled out any fistulous tracts in the pelvis including enterovesical/colovesical fistula. The patient did not report any urinary symptoms and the urinalysis was within normal limits. An extensive infectious workup was negative. Despite the paucity of infectious findings, the EC was empirically treated with an intravenous third-generation cephalosporin. Colonoscopy was significant for multiple ulcerated and hyperemic areas with pseudopolyps all throughout the right, transverse and left colon. Biopsies confirmed Crohn’s colitis with no evidence of granulomata or dysplasia. Immunohistochemistry was negative for CMV. The perianal and abdominal wall lesions were suspected to be pyoderma gangrenosum although biopsies were equivocal. The colitis was initially treated with intravenous steroids followed by biologic therapy with Infliximab. Despite appropriate escalation of therapies, the patient developed colonic perforation requiring subtotal colectomy. Conclusion This is a rare case of EC in a patient with severe Crohn’s colitis. There was no evidence of urinary tract infection or fistulising disease. According to our review, this is the first reported incident of EC in a patient with inflammatory bowel disease without any prior intra-abdominal surgeries. While active Crohn’s disease alone is a critical illness, we conclude that concomitant EC may be a poor prognostic factor.

show abstract

Emphysematous cystitis due to Klebsiella pneumoniae

Cited by 6 publications

References 16 publications

A Case of Concomitant Emphysematous Cystitis and Clostridium difficile Colitis with Pneumoperitoneum

A Case of Concomitant Emphysematous Cystitis and Clostridium difficile Colitis with Pneumoperitoneum

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

Emphysematous cystitis as a potential marker of severe Crohn's disease

Contact Info

Product

Resources

About