A case of urinary system infection requiring hospitalization: Emphysematous cystitis

Abstract

Introduction This study describes the clinical course of a patient with type 2 DM and obesity who was diagnosed with a rare EC; early and effective treatment prevented the development of sepsis and mortality. Case Report A 52-year-old female patient presented to the emergency department with complaints of fever and pain in the inguinal region. The patient patient had known hypertension, DM, and obesity. A physical examination revealed tenderness and defense in the right and left lower quadrants of the abdomen. Other system examinations were normal. Laboratory analyses revealed the following: CRP (C-reactive protein) 439 mg/dl, glucose 343 mg/dl, urea 95.9 mg/dl, creatinine 2.11 mg/dl; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values were within normal limits. In the abdominal CT, air density was observed in the bladder lumen. She was admitted to the infectious diseases clinic with a preliminary diagnosis of urinary system infection. Hydration therapy was continued. Piperacillin tazobactam and ceftriaxone treatment was started. The patient was discharged with recommendations on the 12th day of hospitalization. Conclusion When evaluating urinary system infections in diabetic patients, EC should be included in the differential diagnosis. With hospitalization and effective treatment, the disease can be treated before it progresses to sepsis.

Keywords

• Emphysematous cystitis,
• urinary system infection
• diabetes mellitus

Hastane yatışı gerektiren bir üriner sistem enfeksiyonu vakası: Amfizematöz sistit

Abstract

Amaç Tip 2 DM ve obezitesi olan ve nadir görülen amfizematöz sistit tanısı alan hastanın klinik seyrini anlatmak ve bu sayede erken taburculuğun önlenerek, etkin tedavi ile sepsis gelişimini ve mortaliyteyi engellemek amaçlanmıştır. Olgu Sunumu 52 yaşında kadın hasta, kasıkta ağrı ve ateş şikayeti ile acil servise başvurdu. Bilinen Hipertansiyon, diyabetes mellitus ve obezite hastalıkları mevcuttıu. Fizik muayenede batında sağ ve sol alt kadranda hassasiyet ve defans mevcuttu. Diğer sistem muayeneleri normal idi. Labaratuvar tetkiklerinde CRP( c reaktif protein):439 mg/dl, glukoz:343 mg/dl, üre:95,9 mg/dl, kreatinin:2,11 mg/dl olup olup ALT(alanin aminotransferaz) ve AST(aspartat aminotransferaz) değerleri normal sınırlarda idi. Batın BT’de mesane lümeninde hava dansitesi izlendi. Üriner sistem enfeksiyonu ön tanısı ile enfeksiyon hastalıkları kliniğine yatırıldı. Hidrasyon tedavisi ile birlikte piperasilin tazobactam ve seftriakson tedavisi başlandı. Yatışının 12. Gününde öneriler ile taburcu edildi. Sonuç Diyabetik hastalarda üriner sistem enfeksiyonları değerlendirilirken; amfizematöz sistit ayırıcı tanıda mutlaka yerini almalıdır. Hastane yatışı ve etkin tedavi ile hastalık sepsise ilerlemeden tedavi edilebilmektedir.

Keywords

• Amfizematöz sistit, üriner sistem enfeksiyonu, diyabetes mellitus

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