Unexpected Etiology of Pure Macroscopic Hematuria: Emphysematous Cystitis

Abstract

Introduction: Emphysematous cystitis (EC) is a rare type of urinary tract infection characterized by the presence of gas in the bladder lumen. It is usually encountered in older women with uncontrolled diabetes mellitus (DM). Patients usually present with dysuria, hematuria, suprapubic pain, and less frequently, with pneumaturia. For definitive diagnosis, pathological examination is required but in most cases, computed tomography (CT) is adequate. With appropriate antibiotherapy and drainage; EC can be managed.Case Report: A 78-year-old woman who presented presented with hematuria was diagnosed with EC via CT scan. The patient was treated with antibiotherapy and placement of urethral Foley catheter.Conclusion: In the diagnosis and treatment of urinary tract infection in elderly women with uncontrolled DM, EC should be kept in mind because of its complications, and for suspicious cases, CT should be performed

Keywords

• Cystitis, diabetes, emphysematous, hematuria

References

1. Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphy- sematous cystitis: a review of 135 cases. BJU Int 2007; 100: 17-20. [CrossRef]
2. Grupper M, Kravtsov A, Potasman I. Emphysematous cystitis: illustrative case report and review of the literature. Medicine (Baltimore) 2007; 86: 47-53.
3. Akan O. Rare infections in diabetes. Turkiye Klinikleri J Endocrin-Special Topics 2008; 1: 64-70.
4. Tagowski M, Kamusella P, Andresen R. A rare cause of abdominal pain: emphysematous cystitis. Rofo 2013; 184: 998-9. [CrossRef]
5. McCabe JB, Mc-Ginn Merritt W, Olsson D, Wright V, Camporesi EM. Em- physematous cystitis: rapid resolution of symptoms with hyperbaric treatment: a case report. Undersea Hyperb Med 2004; 31: 281-4.
6. Perlmutter AE, Mastromichaelis M, Zaslau S. Emphysematous cystitis: a case report and literature review. W V Med J 2004; 100: 232-3.