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Revista médica de Chile

versão impressa ISSN 0034-9887

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DE ARCE ONATE, Edith Pérez; SANHUEZA, María Eugenia; TORRES, Rubén  e  SEGOVIA, Erico. Emphysematous cystitis: Report of one case. Rev. méd. Chile [online]. 2014, vol.142, n.1, pp.114-117. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872014000100018.

We report a 53 year-old woman with type 2 diabetes mellitus and hypertension, presenting with progressive abdominal pain lasting three weeks, associated with lower abdominal swelling and fever. Clinical examination showed a large increase in abdominal volume, contraction of extracellular compartment, and signs of severe sepsis. Computed tomography showed an over-distended bladder with severe wall and luminal pneumatosis and bilateral hydronephrosis. The diagnosis was of emphysematous cystitis associated to hydronephrosis. Urine and blood cultures were positive for multi-susceptible Escherichia coli. Clinical evolution was favorable after 6 weeks of ceftriaxone and urinary catheter use. Emphysematous cystitis is a rare clinical entity, with an associated mortality of 7%. Known predisposing factors are older age, female gender and presence of diabetes. Microbiological agents most frequently involved are Escherichia coli and Klebsiella pneumoniae (80% of cases). Medical treatment is preferred and is based on urinary tract decompression with a bladder catheter, and prolonged broad spectrum antimicrobial therapy.

Palavras-chave : Cystitis; emphysematous; Escherichia coli; Hydronephrosis.

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