Emphysematous cystitis: a 6-year experience with 13 cases

Abstract

Background: Emphysematous cystitis (EC) is a rare urinary tract infection (UTI) with nonspecific clinical manifestations. Most cases are found in patients with diabetes mellitus (DM). Early diagnosis and treatment are important for the prognosis. Objective: The purpose of our study is to analyze the features of patients with EC for the epidemiology, microbiology, clinical symptoms, imaging examination, treatment, prognosis, and prevention. Materials and Methods: We summarized the clinical data of 13 patients with EC for medical history, laboratory and radiological examinations, treatments, and results. We analyzed the reported risk factors to determine whether these factors were related to the failure of conservative treatment. Results: All but one of the patients were women, and all but one had DM. All patients were diagnosed using computed tomography (CT). Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the two major microbes identified in our series, accounting for 69.3%. Twelve (92.3%) patients received conservative management, and one underwent partial cystectomy. All the patients recovered and no death was recorded. Conclusion: EC is a gas-forming UTI common in women with DM. Early diagnosis and appropriate treatment are required to prevent surgical intervention.