Emphysematous Cystitis

Adeyemi, Oluwadamilola A; Flaherty, John F.

doi:10.7759/cureus.11723

Cited by 8 publications

(11 citation statements)

References 5 publications

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“…However, pyocystis is unlikely in this case because it has been reported in oliguric patients, such as patients with supravesical urinary diversion or hemodialysis-dependent patients [14] . Although there is no report of emphysematous cystitis due to S. salivarius infection [1] , [2] , [15] , [16] , S. salivarius can lead to gas formation. The urease system in S. salivarius breaks down urea to ammonia and CO 2 [17] .…”

Section: Discussionmentioning

confidence: 99%

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Emphysematous cystitis due to Streptococcus salivarius infection in a patient with a neurogenic bladder

Okada

Ichimura

Iinuma

2022

IDCases

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Streptococcus salivarius ( S. salivarius ) is an oral commensal bacterium that rarely causes disease. Here, we report a case of emphysematous cystitis due to S. salivarius infection in a patient with a neurogenic bladder. A 56-year-old woman was hospitalized and managed for left putamen hemorrhage. Afterward, she developed poor oral intake. Although the patient was afebrile, laboratory test results suggested an inflammatory response. Urinalysis revealed pyuria and hematuria. Abdominal computed tomography revealed a thickened urinary bladder wall and intraluminal gas. Additionally, she was diagnosed with a neurogenic bladder as she had approximately 200 mL of residual urine. The patient was diagnosed with emphysematous cystitis, and S. salivarius was isolated from urine culture specimens. The patient’s condition improved immediately after treatment, which included bladder drainage and administration of appropriate antibiotics. We could not find any report on S. salivarius causing urinary tract infections, such as emphysematous cystitis. Accordingly, we report this case along with a review of the literature.

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Section: Discussionmentioning

confidence: 99%

“…The mean age of emphysematous cystitis occurrence is approximately 66 years, and it occurs twice as often in women than in men [1] . Diabetes mellitus and urinary stasis are well-recognized risk factors [2] . In emphysematous cystitis, Escherichia coli and Klebsiella pneumoniae are often isolated from urine cultures [1] .…”

Section: Discussionmentioning

confidence: 99%

Emphysematous cystitis due to Streptococcus salivarius infection in a patient with a neurogenic bladder

Okada

Ichimura

Iinuma

2022

IDCases

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“…Age older than 60 accounted for three-quarters of EC patients, and females were the predominant gender with an incidence of 63.7–65.5% [ 2 , 3 ]. Therefore, we considered older age to contribute to the higher mortality rate [ 2 , 3 , 15 , 16 , 17 ]. In addition, risk factors in EC have been thoroughly investigated, including DM, recurrent UTI, neurogenic bladder (NB), bladder outlet obstruction, blood supply disorders, and prolonged catheterization [ 2 , 14 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Scoring Systems to Evaluate the Mortality Risk of Patients with Emphysematous Cystitis: A Retrospective Observational Study

Chen

Hsieh

et al. 2023

JPM

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Background: Emphysematous cystitis (EC) is a complicated urinary tract infection (UTI) characterized by gas formation within the bladder wall and lumen. Immunocompetent people are less likely to suffer from complicated UTIs, but EC usually occurs in women with poorly controlled diabetes mellitus (DM). Other risk factors of EC include recurrent UTI, neurogenic bladder disorder, blood supply disorders, and prolonged catheterization, but DM is still the most important of all aspects. Our study investigated clinical scores in predicting clinical outcomes of patients with EC. Our analysis is unique in predicting EC clinical outcomes by using scoring system performance. Materials and Methods: We retrospectively collected EC patient data from the electronic clinical database of Taichung Veterans General Hospital between January 2007 and December 2020. Urinary cultures and computerized tomography confirmed EC. In addition, we investigated the demographics, clinical characteristics, and laboratory data for analysis. Finally, we used a variety of clinical scoring systems as a predictor of clinical outcomes. Results: A total of 35 patients had confirmed EC, including 11 males (31.4%) and 24 females (68.6%), with a mean age of 69.1 ± 11.4 years. Their hospital stay averaged 19.9 ± 15.5 days. The in-hospital mortality rate was 22.9%. The Mortality in Emergency Department Sepsis (MEDS) score was 5.4 ± 4.7 for survivors and 11.8 ± 5.3 for non-survivors (p = 0.005). For mortality risk prediction, the AUC of ROC was 0.819 for MEDS and 0.685 for Rapid Emergency Medicine Score (REMS). The hazard ratio of univariate and multivariate logistic regression analyses of REMS for EC patients was1.457 (p = 0.011) and 1.374 (p = 0.025), respectively. Conclusion: Physicians must pay attention to high-risk patients according to clinical clues and arrange imaging studies as soon as possible to confirm the diagnosis of EC. MEDS and REMS are helpful for clinical staff in predicting the clinical outcome of EC patients. If EC patients feature higher scores of MEDS (≥12) and REMS (≥10), they will have higher mortality.

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“…Macrophages are found in the normal kidney and in increased numbers in the diseased kidney, where they act as key players in kidney injury, inflammation, and fibrosis [10]. Classically activated macrophages (M1 macrophages) and alternatively activated macrophages (M2 macrophages) are two main phenotypes [11]. M2 macrophages have anti-inflammatory functions and are involved in parasite containment, wound healing, and fibrosis, while M1 macrophages exert pro-inflammatory effects, mediate antimicrobial defense, and antitumor immunity [12].…”

Section: Introductionmentioning

confidence: 99%

Urine Macrophages Polarization Predicts Renal Function Recovery after Nephron-Sparing Surgery in Patients with Renal Cell Carcinoma

et al. 2022

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Introduction: This study was conducted to investigate the underlying associations between urine macrophages polarization and renal function recovery after nephron-sparing surgery (NSS) in patients with renal cell carcinoma (RCC) and to explore the potential application values of urine macrophages polarization in predicting the severity of renal ischemia/reperfusion injury (RIRI). Methods: Sixty-two patients with unilateral RCC who underwent NSS in our departments were prospectively recorded and followed up for long-term renal function to assess the onset of acute kidney injury (AKI) and chronic kidney disease (CKD). Urine samples of patients were collected 72 h after surgery for analyzing pro-inflammatory (classically activated/M1) and pro-reparative (alternatively activated/M2) macrophages polarization by flow cytometry. The detailed correlations between urine macrophages polarization and renal function recovery after NSS were explored by statistical analyses. Results: The cumulative incidence of postoperative AKI was 27.4% (17/62), and 47.0% (8/17) of those eventually developed to CKD during the follow-up. The mean urine M1/M2 ratio was 10.54 ± 8.13 in the AKI group and 3.93 ± 3.10 in the non-AKI group, presenting a significant statistical difference (p < 0.0001). Meanwhile, the urine M1/M2 ratio presented amazing potential in predicting postoperative CKD as well, with a mean ratio of 12.54 ± 9.41 in the CKD group and 4.28 ± 3.21 in the non-CKD group (p < 0.0001). Though univariate analysis implied that urine M1/M2 ratio was a relevant factor of both postoperative AKI and CKD in NSS surgical patients, multivariate analysis did not show satisfying predicting potential in postoperative CKD, mainly due to the very limited candidates enrolled in this study. Conclusion: Urine macrophages polarization could predict renal function recovery after NSS in patients with RCC. The urine M1/M2 ratio might a potential biomarker of RIRI but needs to be further verified in clinical settings.

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Emphysematous Cystitis

Cited by 8 publications

References 5 publications

Emphysematous cystitis due to Streptococcus salivarius infection in a patient with a neurogenic bladder

Emphysematous cystitis due to Streptococcus salivarius infection in a patient with a neurogenic bladder

Scoring Systems to Evaluate the Mortality Risk of Patients with Emphysematous Cystitis: A Retrospective Observational Study

Urine Macrophages Polarization Predicts Renal Function Recovery after Nephron-Sparing Surgery in Patients with Renal Cell Carcinoma

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