Emphysematous Prostatitis

A 42-year-old man with diabetes presented to the ED with severe dysuria and incontinence. Laboratory studies were notable for pyuria, leukocytosis, elevated C-reactive protein, and hyperglycemia. Radiography showed an atypical focus of gas accumulation behind the right pubic ramus. A 42-year-old man with diabetes presented to the emergency department with severe dysuria and incontinence, which he had had for several days. Laboratory studies were notable for pyuria on urinalysis, leukocytosis (a white-cell count of 10,820 per cubic millimeter), elevated C-reactive protein levels (134.1 mg per liter), hyperglycemia (glucose level, 900 mg per deciliter [50 mmol per liter]), and an elevated level of glycated hemoglobin (11.4%). Radiography of the kidney, ureter, and bladder showed an atypical focus of gas accumulation behind the right pubic ramus (Panel A, arrows). Subsequent computed tomography (CT) of the abdomen revealed emphysematous prostatitis of the . . .