Emphysematous Pyelonephritis, Emphysematous Cystitis, and Emphysematous Ureteritis: A Case Report

Campos, Jaime E; Martinez, Phia A; Rangwala, Umme Salma; Fazli, Wolfut; Rey, C.

doi:10.7759/cureus.29651

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…The criterion standard for diagnosis of EC is currently CT imaging, although plain film imaging can be helpful if a large amount of gas is present in the bladder wall or lumen, as was the case in our patient [ 12 ]. However, ultrasound imaging has emerged as a promising tool, offering valuable insights at the patient’s bedside, including possible findings of bubbles in the inferior vena cava or pathognomonic hyperechoic bladder-ring as potential indicators of the disease [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Emphysematous Cystitis: A Rare Urologic Emergency

Paola Pérez Riveros,

Mohseni

2023

Am J Case Rep

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Patient: Female, 67-year-old Final Diagnosis: Emphysematous cystitis Symptoms: Abdominal pain • dysuria • hematuria Clinical Procedure: Computed tomography • foley catheterization • intravenous antibiotic Specialty: Infectious Diseases • General and Internal Medicine • Urology Objective: Rare disease Background: Emphysematous cystitis is a rare urologic condition typically characterized by abdominal pain, hematuria, and dysuria. In some cases, complications such as bladder rupture, necrosis, and septic shock have been reported. Emphysematous cystitis has been associated with several predisposing medical conditions, such as diabetes mellitus, recurrent urinary tract infections, and immunosuppression, but can also infrequently present in an undifferentiated fashion without these aforementioned risk factors, such as in our patient’s case. Case Report: We describe a rare case of emphysematous cystitis in a 67-year-old woman presenting to the Emergency Department with hematuria. The patient’s presenting symptoms also included severe lower abdominal pain and dysuria. Examination revealed suprapubic tenderness and gross hematuria. Imaging revealed gas within the bladder lumen and throughout the bladder wall. Radiography showed concerns for emphysematous cystitis, without evidence of bladder fistula formation with adjacent bowel loops or cysto-vaginal fistula. After consultation with the Urology Department, the patient was admitted for serial examinations, intravenous antibiotics, and continued monitoring. The patient was discharged in good condition after a 3-day hospitalization. Conclusions: Clinicians evaluating patients for acute urologic symptoms should be alert to the possible diagnosis of emphysematous cystitis, given the potential for deterioration and concomitant complications. Although our patient’s presentation included no traditional risk factors for emphysematous cholecystitis, she required hospitalization to ensure progressive improvement. Therefore, prompt management along with appropriate consultation with specialists are crucial to mitigate the risk of adverse outcomes in this rare urologic emergency.

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Section: Discussionmentioning

confidence: 99%

Emphysematous Cystitis: A Rare Urologic Emergency

Paola Pérez Riveros,

Mohseni

2023

Am J Case Rep

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“…Diabetes mellitus is seen in up to 95% of cases of EPN (5). It is commonly seen in females than in males, early diagnosis and treatment is possible providing a better outcome (1,6). EPN is also caused due to presence of risk factors like intravenous drug users, Malnutrition study subjects, subjects with neurogenic bladder, alcoholic subjects, and subjects with anatomical abnormalities in urinary tract (1,7).…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Double J Stenting in the Management of Emphysematous Pyelonephritis

Jamale

Patil

Shalu

et al. 2023

PIJR

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Introduction: EPN is a severe infection of the renal parenchyma, which can be severe and life-threatening condition characterized by the presence of gas in the renal parenchyma, or perinephric tissues. In this study, we wanted to study the efficacy of double J stenting vs conservative management in cases of EPN. 30 cases of EPN Material and methods: were admitted in our institute in respect to age, sex, co-morbidities, urinalysis and ICU stay, antibiotics used and outcomes were analyzed following conservative management vs double J stenting with medical management. Results: All patients improved in both medical and surgical plus medical management; however, it was seen that patients undergoing double j stenting had lesser morbidity and mortality in terms of ICU stay, Antibiotic use and better outcome in comparison to patients undergoing conservative management alone. There was no mortality reported in our study Conclusion: Emphysematous pyelonephritis is a condition associated with high mortality of almost 13-25%, therefore it requires an aggressive management and our study has shown that patients managed with double J stenting along with medical management can be recommended over medical management alone

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“…Certain common organisms associated with the disease include E. coli, K. pneumoniae, P. mirabilis, among others. 1,2 Nonspecific signs and symptoms such as flank pain, vomiting, fever, dysuria, and urgency make diagnosing emphysematous cystitis a challenge, and delay in diagnosis and treatment can cause dissemination of the infection to the ureters and kidneys, increasing mortality.…”

Section: Introductionmentioning

confidence: 99%

A Life-threatening Case of Emphysematous Cystitis with Large Bladder Stones

Fernandez,

Porto,

Alvarez

et al. 2023

Journal of Brown Hospital Medicine

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Emphysematous cystitis is a life-threatening condition that can arise from complicated urinary tract infections. It is especially common in patients with poorly controlled diabetes mellitus. Common pathogens associated with this entity include E. coli, K. pneumoniae, P. mirabilis, among others. We present a case of a 69-year-old male with underlying benign prostatic hyperplasia and type II diabetes mellitus presenting with left-sided flank pain, nausea, gross hematuria, nausea, and vomiting. Computer tomography of the abdomen and pelvis revealed two large bladder stones (up to 4.5cm), trace intraluminal air in the bladder, and an enlarged prostate. Urine cultures grew Extended-Spectrum Beta-Lactamase (ESBL) E. coli, and the patient was treated with Ertapenem and management of underlying comorbidities. The patient was discharged after overall clinical status improvement.

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Emphysematous Pyelonephritis, Emphysematous Cystitis, and Emphysematous Ureteritis: A Case Report

Cited by 4 publications

References 17 publications

Emphysematous Cystitis: A Rare Urologic Emergency

Emphysematous Cystitis: A Rare Urologic Emergency

The Efficacy of Double J Stenting in the Management of Emphysematous Pyelonephritis

A Life-threatening Case of Emphysematous Cystitis with Large Bladder Stones

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