• Daniel Pérez Fentes, Miguel Blanco Parra, José Lema Grille, Valentín Toucedo Caamaño, Serafín Novás Castro, Pedro Lamas Cedrón, and Manuel Villar Núñez.
• Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España. danielfentes@yahoo.es
• Arch. Esp. Urol. 2009 Jun 1;62(5):392-5.

ObjectiveTo report one case of emphysematous cystitis and to review its diagnosis and treatment in the related literature.MethodWe report the case of a type II diabetic 91-year-old woman with jaundice, hematuria, vomits, abdominal pain and poor glycemia control. Diagnosis was obtained by plain abdominal X-ray and ultrasonography, and confirmed by CT. E.coli was isolated in urinary culture.ResultsAntibiotic intravenous therapy with piperacillin-tazo-bactam, urinary bladder catheterization and strict glycemia control. The patient was discharged from hospital on day 5, with 14 additional days of orally administered amoxicillin-clavulanic and bladder catheterization. Complete clinical, radiologic and microbiologic resolution was achieved.ConclusionsEmphysematous cystitis is a rare entity, most common in diabetic women, which results from infection of the urinary bladder with gas-producing pathogens, mainly E.coli. Clinical presentation is variable. Emphysematous cystitis can be diagnosed radiologically, mainly with CT scan. The management consists of broad-spectrum antibiotics, strict glycemic control and bladder drainage. Emphysematous cystitis usually has a benign course, but complications may arise in up to 10-20% of cases, requiring surgical treatment.

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