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A case of emphysematous cystitis caused by Klebsiella pneumoniae

José Ignacio Nolazco, Matías Ignacio González, Gabriel Favre, Guillermo Gueglio, Juan Carlos Tejerizo

Department of Urology, Hospital Italiano de Buenos Aires, Argentina
Address correspondence to Dr. José Ignacio Nolazco, Department of Urology, Hospital Italiano de Buenos Aires, Juan D. Peron 4190, C1181ACH CABA, Argentina

Canadian Journal of Urology 2017, 24(4), 8932-8933.

Abstract

Emphysematous cystitis is a rare type of urinary tract infection that is characterized by air pockets within the bladder wall and lumen, which come from gas that is mainly produced by gram-negative bacteria, notably Escherichia coli. This infection is more common in older women with poorly controlled diabetes. An abdominal computerized tomography (CT) scan is the gold standard method to make the diagnosis. The infection can be life-threatening, so prompt treatment is essential.
We present a case of a 39-year-old woman with poorly controlled type 2 diabetes who developed emphysematous cystitis after a bilateral adrenalectomy. The infection was diagnosed by a CT scan that revealed gas in the bladder wall. A urine culture revealed 106 colonies/mL of Klebsiella pneumoniae. After a month of treatment with intravenous antibiotics (vancomycin plus meropenem plus colistin), bladder drainage, and strict glycemic control, the patient had a good outcome.

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