Emphysematous cystitis, the importance of an early diagnosis: a case report and bibliographic review

Abstract

Clinical case description: 86-year-old patient, hypertensive, who came to the emergency room due to a poor general condition, desaturation and elevation of acute phase reactants. In this context, several complementary tests are performed, including radiological tests that reveal ectopic air in the bladder wall compatible with emphysematous cystitis. Hospital admission was decided for intravenous antibiotic therapy and evolutionary control. During her admission the patient presented a torpid and rapid evolution, suffering a hemodynamic deterioration producing fatal death on admission due to multiorgan failure.

Relevance: Emphysematous cystitis is an infectious condition of rare presentation and more frequent in diabetic female patients, characterized by the presence of gas in the bladder cavity. The peculiarity of our case is due to the fact that the patient did not have diabetes, and this pathology is much more common in diabetic patients.

Clinical implications: An early diagnostic suspicion is of vital importance, especially in decompensated insulin-dependent patients with urinary infection. Imaging findings are characteristic of this pathology and constitute the differential element of its definitive diagnosis.

Conclusions: Emphysematous cystitis is an unusual pathology, but it can present high morbidity and mortality. In most cases, it has a good prognosis with antibiotic treatment and good glycemic control.