No abstract

Emphysematous cystitis is a rare disease caused by gas fermenting bacterial and fungal pathogens. Clinical symptoms are non-specific and diagnostic clues often arise from the unanticipated imaging findings. The clinical manifestations can vary from an incidental diagnosis on abdominal imaging to severe sepsis. Gas-forming infections of the urinary tract (emphysematous nephritis, pyelitis and cystitis) are potentially life-threatening and require prompt evaluation and management. We describe a case of a male patient with diabetes and neurogenic bladder due to spinal cord injury diagnosed to have emphysematous cystitis that was managed successfully with strict glycemic control, intravenous antibiotics, bladder irrigation with antibiotics and cystoscopy removal of necrotic tissue.

Tuberous sclerosis is an autosomal dominant disorder characterized by multiple hamartoma lesions distributed throughout the body, especially the skin, retina, kidney, heart, central nervous system & lung. 1 It is diagnosed based on ROACH criteria which includes atleast two major and one minor criteria, but our case have four major criteria which is very rare. Tuberous sclerosis associated with gene mutation of TSC1 (OR)TSC2 encoding hamartin & tuberin respectively. 2

In rheumatic heart disease with epilepsy, the cause of epilepsy is due to rheumatic endarteritis, valvular heart disease with arrhythmia and hypotension leading to cerebral vascular insufficiency. (1)