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.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.