Abstract
Emphysematous cystitis (EC) is the presence of intramural gas, with or without luminal gas, within the bladder as a result of a primary infection of the lower urinary tract with a gas-producing organism. It is a well-recognised complication of urinary tract infections involving Escherichia coli in diabetic patients. Clinical subcutaneous emphysema is a rare complication of EC that appears to have poor prognosis. Only careful clinical judgement, and a high degree of suspicion, will lead to its early diagnosis and treatment. Here, we report a case of subcutaneous emphysema due to EC based on a clinical diagnosis confirmed using computed tomography (CT).
Highlights
Emphysematous cystitis (EC) is the presence of intramural gas, with or without luminal gas, within the bladder as a result of a primary infection of the lower urinary tract with a gas-producing organism
We report a case of subcutaneous emphysema due to EC based on a clinical diagnosis confirmed using computed tomography (CT)
We report the first case of subcutaneous emphysema due to EC based on a clinical diagnosis confirmed using CT
Summary
Emphysematous cystitis (EC) is the presence of intramural gas, with or without luminal gas, within the bladder as a result of a primary infection of the lower urinary tract with a gas-producing organism. Case report An 81-year-old lady with poorly controlled non-insulin dependent diabetes presented to our accident and emergency department with increased frailty and confusion following review by her GP She had been discharged 10 days earlier following treatment for a lower respiratory tract infection. All intravenous antibiotics were stopped, and the patient passed away 5 days later (a total of 21 days after her most recent admission) Prior to this admission and above diagnoses, the patient’s other significant medical history included essential hypertension, diverticulosis, leg cramps, orthostatic pedal oedema, previous mastectomy of the left breast for invasive ductal carcinoma, right delta shoulder joint replacement following a rotator cuff tear and hiatus hernia. Frusemide 40 mg; twice daily loperamide 2 mg, metformin 1 g and ranitidine 150 mg; and three times daily metoclopramide 10 mg and temezepam 10 mg pro re nata
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