Emphysematous Cystitis: A Fatal Complication of Uncontrolled Type-2 Diabetes Mellitus

Emphysematous cystitis (EC) is a rare type of complicated urinary tract infection mostly seen in elderly females with diabetes, characterized by gas within the bladder lumen and wall. The presenting symptoms are variable, ranging from no symptoms to severe sepsis. The commonly isolated organisms in...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-10, Vol.14 (10)
Main Authors: Raval, Darshankumar M, Rathod, Vaishnavi M, Patel, Nilay S, Dobariya, Riya, Sharma, Bhavya
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Antigens
Bladder
Case reports
Complaints
Diabetes
E coli
Edema
Females
Hematuria
Hemoglobin
Hepatitis
Hypertension
Insulin
Internal Medicine
Kidneys
Mortality
Nephrology
Patients
Proteins
Sepsis
Tomography
Ultrasonic imaging
Urinary tract infections
Urine
Urogenital system
Urology
Ventilators
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Summary:Emphysematous cystitis (EC) is a rare type of complicated urinary tract infection mostly seen in elderly females with diabetes, characterized by gas within the bladder lumen and wall. The presenting symptoms are variable, ranging from no symptoms to severe sepsis. The commonly isolated organisms in urine cultures are Escherichia coli and Klebsiella pneumoniae. Imaging studies, namely plain conventional abdominal radiography and computed tomography, are necessary to make a definitive diagnosis of EC. The management includes medical treatment with culture-guided antibiotics, whereas surgical intervention such as cystectomy is rarely required in severe cases. Here, we have a case of a 48-year-old diabetic female diagnosed with EC on radio imaging. The patient was aggressively treated with higher antibiotics such as piperacillin/tazobactam, clindamycin, and fosfomycin along with measures to control blood sugars. However, she developed severe sepsis and succumbed to death. Our report presents one of the rare cases of EC as a life-threatening complication in diabetics, suggesting that every case of urinary tract infection in uncontrolled diabetics should be thoroughly investigated and treated to prevent fatal complications.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.30028