Volume 198 - Issue 9
Emphysematous cystitis due to Klebsiella pneumoniae
Authors: Mohammad Bagherirad and Hasan Al-Khayyat
Med J Aust 2013; 198 (9): 506. || doi: 10.5694/mja12.11387
Published online: 20 May 2013
Published online: 20 May 2013
A 72-year-old woman with type 2 diabetes mellitus presented with sudden-onset back pain, fever, rigors and suprapubic tenderness. An abdominal x-ray and pelvic computed tomography scan (Figure) confirmed the diagnosis of emphysematous cystitis. Klebsiella pneumoniae was cultured from blood and urine samples, and the patient was treated with intravenous cephazolin followed by oral cephalexin.
She had a complete recovery.
Emphysematous cystitis is an uncommon but severe infection ...
A 72-year-old woman with type 2 diabetes mellitus presented with sudden-onset back pain, fever, rigors and suprapubic tenderness. An abdominal x-ray and pelvic computed tomography scan (Figure) confirmed the diagnosis of emphysematous cystitis. Klebsiella pneumoniae was cultured from blood and urine samples, and the patient was treated with intravenous cephazolin followed by oral cephalexin. She had a complete recovery.
Emphysematous cystitis is an uncommon but severe infection caused by gas-producing pathogens including K. pneumoniae.1 It should be considered in diabetic patients with symptoms of urinary tract infection, severe abdominal or pelvic pain and positive blood cultures.2 A history of pneumaturia is highly suggestive, but is rarely mentioned by patients.3
Computed tomography image of the patient's abdomen
Arrows show gas in the bladder wall.
Acknowledgements
We thank Andrew Hughes and Eugene Athan, our supervisors.
References
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- Ankel F, Wolfson AB, Stapczynski JS. Emphysematous cystitis: a complication of urinary tract infection occurring predominantly in diabetic women. Ann Emerg Med 1990; 19: 404-406. 0_i1115592
- Weddle J, Brunton B, Rittenhouse DR. An unusual presentation of emphysematous cystitis. Am J Emerg Med 1998; 16: 664-666. 0_i1115594