Clinical Outcomes of Nonoperative Management in Emphysematous Urinary Tract Infections

Emphysematous Cystitis: A Review of the Literature

“…EC is a less severe condition than any other gas-forming infection of the urinary tract, with an overall mortality rate of 3-12%. However, when EC occurs in concert with another gas-forming disease within the upper UT, emphysematous pyelonephritis (EP), the mortality rate increases by up to 14-20% (2,3). EC is typically observed in elderly women (60-70 years of age) with severe diabetes mellitus (1,2,4), with cases reported approximately twice as often in women as in men.…”

“…However, when EC occurs in concert with another gas-forming disease within the upper UT, emphysematous pyelonephritis (EP), the mortality rate increases by up to 14-20% (2,3). EC is typically observed in elderly women (60-70 years of age) with severe diabetes mellitus (1,2,4), with cases reported approximately twice as often in women as in men. Traditional risk factors for UTIs, such as DM, neurogenic bladder, recurrent UTI and urinary stasis secondary to bladder outlet obstruction (BOO), are also risk factors for EC because EC is considered to be a form of complicated UTI (1).…”

“…Among the risk factors for EC, DM appears to be the strongest: almost 70% of patients with EC have DM, and women with EC are more likely to have DM than men (70% vs. 60%). One report shows that EC patients have poorly controlled DM, with a median serum glucose level of 293 mg/dL and an HbA1c level of 9.9% (2). The UT of diabetic patients can be damaged by conditions such as diabetic nephropathy, bladder dysfunction due to diabetic neuropathy and renal artery stenosis.…”

<i>Streptococcus pneumoniae</i> Meningitis Presenting with Acute Urinary Retention and Emphysematous Cystitis

“…Emphysematous cystitis is a potentially fatal infection, with an overall mortality rate of 3-12%. When emphysematous cystitis occurs along with another gas-forming disease within the upper urinary tract, emphysematous pyelonephritis, the mortality rate increases by up to 14-20% (14,15). Surgical intervention is regarded as the treatment of choice for gas-forming disease of the urinary tract, especially emphysematous pyelonephritis.…”

Cistitis enfisematosa: una inusual forma de presentación de la infección del tracto urinario bajo

“…El tratamiento estándar consiste en drenaje vesical para reducir la presión intravesical, control glicémico estricto y antibioterapia parenteral de amplio espectro ajustando según antibiograma 16 . El pronóstico suele ser favorable 17 , sin embargo, se pueden presentar complicaciones como sepsis persistente, compromiso de vía urinaria alta y, hasta en 20% de los casos pueden requerir una intervención quirúrgica, asociándose a mayor morbimortalidad 18 . En el caso presentado, el diagnóstico y tratamiento precoz, probablemente, influyó en la buena evolución.…”