Emphysematous Prostatitis and Cystitis Secondary toCandida Albicans

Bartkowski, Donald P.; Lanesky, John R.

doi:10.1016/s0022-5347(17)42774-1

Cited by 74 publications

(29 citation statements)

References 8 publications

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“…[1][2][3][4][5][6][7][8] Emphysematous cystitis, which almost exclusively occurs in patients with diabetes mellitus, is rare and is rarely the result of a fungus. 9,10 To our knowledge, this is the second report of a bladder fungus ball occurring simultaneously with emphysematous cystitis. 2 The predisposing factors were diabetes mellitus and usage of broad-spectrum antibiotics.…”

Section: Discussionmentioning

confidence: 74%

Fungus ball and emphysematous cystitis secondary to Candida tropicalis: A case report

Wang

Sun

et al. 2015

CUAJ

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Fungus ball and fungal emphysematous cystitis are two rare complications of fungal urinary tract infection. A 53-year-old male patient presented with these complications caused by Candida tropicalis simultaneously. The predisposing factors were diabetes mellitus and usage of broad-spectrum antibiotics. The fungus ball, measuring 3.5 × 2.0 cm on the left wall of the urinary bladder, shrank significantly to 1.6 × 0.8 cm after 5 days of intermittent irrigation with saline before surgery. With transurethral removal of the fungus ball and antifungal treatment with fluconazole, the patient fully recovered. We conclude that a bladder fungus ball and fungal emphysematous cystitis should always be suspected in patients with diabetes mellitus with uncontrolled funguria and abnormal imaging. Treatment should include a systemic antifungal therapy and thorough surgical removal of the fungus ball. A systemic antifungal therapy combined with a local irrigation with saline or antifungal drugs might help decrease the dissemination of fungemia during an invasive manipulation. Case reportA 53-year-old male was referred to our department in February 2015 with intermittent, but recently aggravated cloudy urine. The symptom had been ongoing for 9 years, sometimes with frequency and urgency. No blood urine or fever was ever reported. To control the symptoms of cystitis, the patient underwent multiple treatments with broadspectrum antibiotics during this 9-year period. Twice, fungus was found in his urine (9 years and 6 years ago).The patient had uncontrolled type II diabetes mellitus for more than a decade. He also suffered from a right kidney stone and underwent a percutaneous nephrolithotomy 18 years ago. Physical examination was unremarkable. A routine urine test showed significantly elevated red blood cells (56.1/HP, normal <4.5/HP) and white blood cells (328.7/HP, normal <5.4/HP). Blood tests were normal, except for an elevated fasting glucose level of 7.7 (range: 3.6-6.1) mmol/L. Sonography revealed a medium-to hypo-echoic bladder tumour, measuring 3.5 × 2.0 cm. It was located on the left wall of the urinary bladder, did not move with posture changes, and had no sign of blood flow (Fig. 1a). A computed tomography (CT) revealed no intravesical mass in either the unenhanced or dual-enhanced phase. Only a very faint filling defect was found in the excretory phase. Moreover, a large round gas collection was found in the bladder, and a 1.1 × 0.9-cm calculus revealed a right distal ureter, leading to mild unilateral hydronephrosis and ureterectasis (Fig. 1b).Urinary cytology showed a large number of hyphae and neutrophil granulocytes. Candida tropicalis was isolated from the urine, but the blood culture was negative. Because a fungus ball secondary to Candida tropicalis was highly suspected at this time, intermittent bladder washouts with saline (2 L per time and 3 times per day) were performed via an indwelling three-cavity urinary catheter. A mass of floccules were flushed out during early irrigation. A rechecked sonography ...

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Section: Discussionmentioning

confidence: 74%

Fungus ball and emphysematous cystitis secondary to Candida tropicalis: A case report

Wang

Sun

et al. 2015

CUAJ

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“…The most known E-type coliform bacteria and Klebsiella account for 70% of such primary causative organisms (2,4,8,9). However, we regret not to be able to identify the primary causative organism in the present case since the urinary sample was cultured only after administering antibiotics.…”

Section: Discussionmentioning

confidence: 79%

Emphysematous Cystitis with Severe Hemorrhagic Anemia Resulting from Diabetes Mellitus Type 2

et al. 2004

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A 48-year-old woman suffering from hematuria was admitted to our hospital due to conscious disturbance. She had lower abdominal phantom tumor, anemia, renal dysfunction, hyperglycemia, metabolic acidosis and electrolyte abnormalities. Because of pelvocaliceal dilatation noted on abdominal ultrasonography, we first diagnosed her as having postrenal failure. With massive blood clots and gas emission from her urethra upon attempting cystoscopy, the remarkable expansion of the urinary bladder and a three-layered structure of gas, urine and complex of blood and debris inside her urinary bladder noted on abdominal CT scan, as well as the increased white blood cell count, we finally concluded our diagnosis as emphysematous cystitis. (Internal Medicine 43: 315-318, 2004)

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“…A delayed diagnosis can cause high mortality and morbidity, so a prompt clinical diagnosis of this condition is essential [1][2][3][4][5]. The majority of patients present in their fifth or sixth decade of life and they have other predisposing factors including diabetes mellitus, liver cirrhosis, intravesical obstruction and prior genitourinary tract instrumentation and bladder catheterization [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients present in their fifth or sixth decade of life and they have other predisposing factors including diabetes mellitus, liver cirrhosis, intravesical obstruction and prior genitourinary tract instrumentation and bladder catheterization [1][2][3][4][5]. This disease can be diagnosed at an early stage with advanced diagnostic modalities such as ultrasound, CT or MRI [1][2][3][4][5]. Appropriate antibiotics with early incision and drainage may result in favorable outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…This disease entity requires special attention by physicians due to its nonspecific presentation such as dysuria, DOI: 10.3947/ic.2011.43.1.64 • Infect Chemother 2011;43(1):64-67 65 www.icjournal.org frequency, urgency, fever, acute urinary retention and/or perineal pain [1][2][3][4][5]. Some authors have demonstrated that this condition is an uncommon, but relatively serious disease with high mortality and morbidity [1][2][3][4][5]. We report herein on a case of emphysematous prostatitis combined with liver abscess caused by K. pneumoniae.…”

Section: Introductionmentioning

confidence: 99%

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Emphysematous prostatitis combined with a liver abscess caused byKlebsiella pneumoniae

et al. 2011

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Emphysematous prostatitis combined with a liver ab scess caused by Klebsiella pneumoniae Emphysematous prostatitis is a rare condition that is characterized by gas and abscess accumulation in the prostate. This uncommon but serious disease requires special attention because of its nonspecific presentation such as dysuria, frequency, urgency, fever, acute urinary retension and/or perineal pain. We report here on a case of emphysematous prostatitis that was combined with a liver abscess caused by Klebsiella pneumoniae. A 55yearold man was admitted due to a 3day history of urinary retention with a febrile sensation. He had histories of liver cirrhosis and uncontrolled diabetes mellitus. After blood and urine cultures, levofloxacin 500 mg was started intravenously. On the third hospital day, he displayed septic shock.The kidneysureters bladder (KUB) Xray showed pockets of airaccumulation in the lower pelvic cavity, and abdominopelvic computed tomography (CT) with contrast enhancement taken on the third day showed a 5cm liver abscess with an emphysematous prostate. Intravenous antibiotics was changed to metronidazole 500 mg q.i.d. and cefotaxime 2 g t.i.d. On the sixth day, transurethral resection and drainage were performed under spinal anesthesia. However, the postoperative bleeding continued and hypovolemic shock persisted, which then provoked multiorgan failure. The patient died on the 11th hospital day. K. pneumoniae was cultured from the liver abscess aspirate, blood and prostatic tissue, and the bacteria were sensitive to both levofloxacin and cefotaxime. Emphysematous prostatitis is a difficult to diagnose because of its rarity and nonspecific symptoms. A delayed diagnosis can cause high mortality and morbidity, so making a prompt clinical diagnosis of this condition is essential. Appropriate antibiotics with early adequate incision and drainage are also needed.

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Emphysematous Prostatitis and Cystitis Secondary toCandida Albicans

Cited by 74 publications

References 8 publications

Fungus ball and emphysematous cystitis secondary to Candida tropicalis: A case report

Fungus ball and emphysematous cystitis secondary to Candida tropicalis: A case report

Emphysematous Cystitis with Severe Hemorrhagic Anemia Resulting from Diabetes Mellitus Type 2

Emphysematous prostatitis combined with a liver abscess caused byKlebsiella pneumoniae

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