Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.
References
[1]
Thomas, A.A., Lane, B.R., Thomas, A.Z., Remer, E.M., Campbell, S.C. and Shoskes, D.A. (2007) Emphysematous Cystitis: A Review of 135 Cases. BJU International, 100, 17-20. https://doi.org/10.1111/j.1464-410X.2007.06930.x
Bailey, H. (1961) Cystitis Emphysematosis; 19 Cases with Intraluminal and Interstitial Collections of Gas. American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine, 86, 850-862.
[4]
Roy, C. (2014) Acquired Non-Tumor Pathology of the Bladder. Radiology Leaflets, 54, 84-111. https://doi.org/10.1016/j.frad.2014.03.001
[5]
Souley, A., Tahirou, S., Iken, M., Haloua, M., Alami, B., Alaoui Lamrani, Y., Maaroufi, M. and Boubbou, M. (2020) One Image, One Diagnosis: Emphysematous Cystitis about a Case. Journal ofAfricanClinical Cases and Reviews, 4, 320-325.
[6]
Ouraghi, A., El Houmaidi, A., Mhanna, T., Irzi, M., Chennouf, M., El Moudane, A. and Barki, A. (2020) Emphysematous Cystitis Complicated by Bladder Rupture: A Paraplegic Patient Case. PAMJ-Clinical Medicine, 3, Article 113. https://doi.org/10.11604/pamj-cm.2020.3.113.23778
[7]
Grupper, M., Kravtsov, A. and Potasman, I. (2007) Emphysematous Cystitis: Illustrative Case Report and Review of Literature. Medicine, 86, 47-53. https://doi.org/10.1097/MD.0b013e3180307c3a
[8]
Bracq, A., Fourmarier, M., Bourgninaud, O., Boutemy, F., Demailly, M., Petit, J. and Saint, F. (2004) [Emphysematous Cystitis Complicated by Bladder Perforation: Diagnosis and Treatment of a Rare Observation]. Progres en Urologie: Journal de l’Association Francaise d’Urologie et de la Societe Francaise d’Urologie, 14, 87-89.
[9]
Dauchy, F.A., Devars, D. and Lifermann, F. (2004) Emphysematous Cystitis Indicative of Diabetes. Annales d’Endocrinologie, 65,176-178. https://doi.org/10.1016/S0003-4266(04)95667-3
[10]
Clémençot, A., Meyrieux, A. and Schneider, T. (2019) Emphysematous Cystitis. European Journal of Emergencies and Resuscitation, 31, 57-59. https://doi.org/10.1016/j.jeurea.2018.12.002
[11]
Le Duc, A., De Montgolfier, S. and Carioug Michon, J. (1983) Emphysematous Pneumatogenous Cystitis. Annals ofUrology, 17, 250-253.
[12]
Azeddine, E., Keita, M.M., Amine, L.M., Zakaria, D., Said, M.M. and Ismail, S. (2020) Hemorrhagic Emphysematous Cystitis: Report of a Case. PAMJ-Clinical Medicine, 4, Article 100. https://doi.org/10.11604/pamj-cm.2020.4.100.26346
[13]
Bjurlin, M.A., Hurley, S.D., Kim, D.Y., et al. (2012) Clinical Outcomes of Non-Operative Management in Emphysema Urinary Tract Infections. Urology, 79, 1281-1285. https://doi.org/10.1016/j.urology.2012.02.023
[14]
Amano, M. and Shimizu, T. (2014) Emphysematous Cystitis: A Review of the Literature. Internal Medicine, 53, 79-82. https://doi.org/10.2169/internalmedicine.53.1121
[15]
Ankel, F., Wolfson, A.B. and Stapczynski, J.S. (1990) Emphysematous Cystitis: A Complication of Urinary Tract Infection Occurring Predominantly in Diabetes Women. Annals of Emergency Medicine, 19, 404-406. https://doi.org/10.1016/S0196-0644(05)82347-9
[16]
Yang, Z. and Sheng, C. (2017) Gas Surrounding the Urinary Bladder in Emphysema Cystitis. International Brazilian Journal of Urology, 43, 1190-1191. https://doi.org/10.1590/s1677-5538.ibju.2016.0555
[17]
Yoshida, K., Murao, K., Fukuda, N., Tamura, Y. and Ishida, T. (2010) Emphysematous Cystitis with Diabetics Neurogenic Bladder. Internal Medicine, 49, 1879-1883. https://doi.org/10.2169/internalmedicine.49.3247
[18]
Barkia, A., Larbi, N., Mnif, A., Chebil, M. and Ayed, M. (1997) [Emphysematous Cystitis: Report of 2 Cases]. Progres en Urologie: Journal de l’Association Francaise d’Urologie et de la Societe Francaise d’Urologie, 7, 468-470.
[19]
Touiti, D., Chavrier, B., Gérard, T., Fassi Fehri, H., Colombel, M., Martin, X. and Dubernard, J.M. (2001) Emphysematous Cystitis: About an Observation. African Journal of Urology, 6, 79-81.
[20]
Yang, W.H. and Shen, N.C. (1990) Gas Forming Infection of the Urinary Tract: An Investigation of Fermentation as a Mechanism. Journal of Urology, 143, 960-964. https://doi.org/10.1016/S0022-5347(17)40151-0
[21]
Eken, A. and Alma, E. (2013) Emphysema Cystitis: The Role of CT Imaging and Appropriate Treatment. Canadian Urological Association Journal, 7, e754-e756. https://doi.org/10.5489/cuaj.472
[22]
Biogeau, J., Lamandé, M., Ripault, H., Léger, I. and Dardaine-Giraud, V. (2018) Emphysematous Cystitis: Report of a Case. The Journal of Internal Medicine, 39, 192-194. https://doi.org/10.1016/j.revmed.2017.12.008
[23]
Jroundi, H. and Omana, J.P. (2019) Emphysematous Cystitis Caused by Klebsiella Pneumoniae with Hepatic Origin. PAMJ-Clinical Medicine, 1, Article 37. https://doi.org/10.11604/pamj-cm.2019.1.37.20899
[24]
Colombel, M. and Labussière Wallet, H. (2018) Hemorrhagic Cystitis: Pathophysiology and Actions to Take. Egydio Medical Center (EMC) Urology, Sao Paulo.
[25]
Egawa, S., Utsunomiya, T., Uchida, T., Mashimo, S. and Koshiba, K. (1994) Emphysematous Pyelonephritis, Ureteritis, and Cystitis in a Diabetic Patient. Urologia Internationalis, 52, 176-178.
[26]
Paparel, P., Cognet, F., Cercueil, J.P., Krause, D. and Michel, F. (2003) Diagnostic and Therapeutic Strategy in Emphysematous Pyelonephritis. Annals ofInternal Medicine, 154, 259-262. https://doi.org/10.1159/000282602
[27]
Quint, H.J., Drach, G.W., Rappaport, W.D. and Hoffmann, C.J. (1992) Emphysematous Cystitis: A Review of the Spectrum of Disease. Journal of Urology, 147, 134-137. https://doi.org/10.1016/S0022-5347(17)37160-4
[28]
Bartkowski, D.P. and Lanesky, J.R. (1988) Emphysematous Prostatitis and Cystitis Secondary to Candida Albicans. Journal of Urology, 139, 1063-1065. https://doi.org/10.1016/S0022-5347(17)42774-1
[29]
Rajaian, S., Murugavithianathan, P., Krishnamurthy, K. and Murugasen, L. (2019) Emphysematous Cystitis: Diagnosed Only If Suspected. BMJ Case Reports, 12, e230715. https://doi.org/10.1136/bcr-2019-230715
[30]
Wroblewski, M. and Mikulowski, P. (1991) Peritonitis in Geriatric Patients. Age and Aging, 20, 90-94. https://doi.org/10.1093/ageing/20.2.90
[31]
Banon Perez, V.J., Garcia Hernandez, J.A., Valdelvira Nadal, P., Nicolas Torralba, J.A., Server Pastor, G., Coves, R., Martinez Barba, E. and Perez Albacete, M. (2000) [Intraperitoneal Bladder Perforation in Emphysematous Cystitis]. Actas Urológicas Españolas, 24, 501-503. https://doi.org/10.1016/S0210-4806(00)72492-2
[32]
Gargouri, M.M., Abid, K., Kallel, Y., Rhouma, S.B., Chelif, M. and Nouira, Y. (2015) Severe Sepsis Secondary to Emphysematous Cystitis. African Journal of Urology, 21, 41-43. https://doi.org/10.1016/j.afju.2014.11.001
[33]
Wortmann, G. and Fleckenstein, J. (1998) Incidental Discovery of Emphysematous Cystitis. Southern Medical Journal, 91, 785-786. https://doi.org/10.1097/00007611-199808000-00020
[34]
Kuo, C.Y., Lin, C.Y., Chen, T.C., et al. (2009) Clinical Features and Prognosis Factors of Emphysema Urinary Tract Infection. Journal of Microbiology, Immunology, and Infection, 42, 393-400.
[35]
Yokoo, T., Awai, T., Yamazaki, H., Fukuda, Y., Hayashi, F. and Hosoya, T. (2007) Emphysematous Cystitis Complication in a Patient Undergoing Hemodialisis. Clinical and Experimental Nephrology, 11, 247-250. https://doi.org/10.1007/s10157-007-0478-3
[36]
Grayson, D.E., Abbott, R.M., Levy, A.D. and Sherman, P.M. (2002) Emphysematous Infections of the Abdomen and Pelvis: A Pictorial Review. RadioGraphics, 22, 543-561. https://doi.org/10.1148/radiographics.22.3.g02ma06543
[37]
Barbier, C., Colbot, F., Jeanmaire, H. and Becker, S. (1993) Emphysematous Cystitis. Journal de Radiologie, 74, 439-440.
[38]
Wu, Y.F., Kao, C.C., Tsuei, Y.W. and Hung, J.B. (2015) Acute Urinary Retention as a Manifestation of Emphysematous Cystitis. The American Journal of Emergency Medicine, 33, 604, e1-e604, e2. https://doi.org/10.1016/j.ajem.2014.09.042
[39]
Stamm, W.E. and Hooton, T.M. (1993) Management of Urinary Tract Infections in Adults. New England Journal of Medicine, 329, 1328-1334. https://doi.org/10.1056/NEJM199310283291808
[40]
O’Connor, L.A. and De Guzman, J. (2001) Emphysematous Cystitis: A X-Ray Diagnosis. The American Journal of Emergency Medicine, 19, 211-213. https://doi.org/10.1053/ajem.2001.23896
[41]
Roels, P., Decaestecker, K. and De Visschere, P. (2016) Spontaneous Bladder Wall Rupture Due to Emphysematous Cystitis. Journal of the Belgian Society of Radiology, 100, 83. https://doi.org/10.5334/jbr-btr.1151
[42]
Zhang, W.-J., Zhu, Z.-M. and Luo, H.-L. (2020) Severe Emphysema Cystitis Complicated with Perforation, Bilateral Renal Cortical Atrophy and Sepsis: A Case Report. Journal of International Medical Research, 48, 1-6. https://doi.org/10.1177/0300060520937920
[43]
Nicolle, L.E., Bradley, S., Colgan, R., et al. (2005) Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asymptomatic Bacteriuria in Adults. Clinical Infectious Diseases,40, 643-654. https://doi.org/10.1086/427507
[44]
Stratton, I.M., Cull, C.A., Adler, A.I., Matthews, D.R., Neil, H.A.W. and Holman, R.R. (2006) Additive Effects of Glycaemia and Blood Pressure Exposure on Risk of Complications in Type 2 Diabetes: A Prospective Observational Study (UKPDS 75). Diabetologia, 49, 1761-1769. https://doi.org/10.1007/s00125-006-0297-1
