Emphysematous Cystitis: A Case Report Emphysematous Cystitis

Introduction: Emphysematous cystitis (EC) is an infectious cystitis characterized by gas formation in the urinary tract and usually caused by gas forming Escherichia coli or Klebsiella pneumoniae strains. The gas accumulates in the bladder wall can be seen by computerized tomography (CT). Therefore, CT is used for accurate diagnosis. Case Report: A 69-year-olddiabetic man had lung adenocarcinoma presented by abdominal pain for a week. He had type 2 diabetes mellitus for two years and he received first chemotherapy cure approximately three weeks before. The patient was oriented, afebrile and normotensive. On physical examination, he has only suprapubic tenderness. Abdomino-pelvic CT was performed, and it showed that bladder wall was diffusely thickened, with the largest measurement of 18 mm. Accumulation of the air within the bladder wall was detected. The result of urine culture revealed more than 20.000 colonies of Klebsiella pneumonia. The patient was diagnosed with emphysematous cystitis then he was hospitalized, and intravenous piperacillin/tazobactam treatment was initiated. Conclusion: It is very important to make a definite diagnosis in EC. EC should be kept in mind in diabetic patients with abdominal pain. Keywords Emphysematous cystitis, Computed tomography References * 1. Gheonea IA, Stoica Z, Bondari S. Emphysematous cystitis: case report and imaging features. Curr Health Sci J. 2012; 38: 191–4. * 2. Tzou K, Chiang Y. Emphysematous Cystitis. N Engl J Med. 2016; 375(18): 1779. * 3. Taşdemir C, Çimen S, Kahraman B, Sağır Kahraman A, Özaydoğdu Çimen A, Turunçet A, et al. A rare cause of acute abdominal pain and gross hematuria: Emphysematous cystitis. The New Journal of Urology. 2016; 11(1): 38-40. * 4. Ergün T, Eldem HO, Lakadamyalı H. A rare cause of acute lower abdominal pain: Emphysematous cystitis. Turk J Urol. 2014; 40: 65– 7. * 5. Tagci S, Ozden C, Gokkaya CS, Aktas BK, Bulut S. Emphysematous cystitis: a case report. J Clin Anal Med. 2016; 7(1): 138-40. * 6. Zeytin AT, Tok S, Kadıoğlu E, Kulan MS. Emphysematous cystitis: A rare cause of abdominal pain. CausaPedia. 2013; 2: 652-5. * 7. Affes N, Bahloul A, Dammek Y, Kallel H, Mzali R, Beyrouti MI. A diabetic patient in septic shock. Emphysematous cystitis. CJEM. 2010; 12: 527-40. * 8. Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphysematous cystitis: a review of 135 cases. DABJU Int. 2007; 100: 17-20. * 9. Toyota N, Ogawa D, Ishii K, Hirata K, Wada J, Shikata K, et al. E