Greene M H
Department of Internal Medicine, Mayo Clinic Scottsdale, AZ 85259.
Cancer. 1992 Dec 1;70(11):2658-63. doi: 10.1002/1097-0142(19921201)70:11<2658::aid-cncr2820701115>3.0.co;2-b.
Fever, abdominal pain, and hematuria developed in two patients with hematologic malignant conditions (multiple myeloma and agnogenic myeloid metaplasia). Each patient was found to have emphysematous cystitis (EC), secondary to Clostridium perfringens and Candida albicans, respectively. Both patients had debilitated general medical conditions, compromised immune function, prior treatment with broad-spectrum antibiotics and corticosteroids, bladder outlet obstruction, and indwelling Foley catheters as predisposing factors to EC. Neither was diabetic.
These cases provide an opportunity to review the related medical literature on the pathophysiology and management of this uncommon entity.
Treatment consists of control of underlying diabetes (if present), administration of appropriate antibiotics, establishment of urinary drainage, provision of supportive general medical care, exclusion of the presence of a bladder fistula, and surgical debridement only when unavoidable.
EC should be part of the differential diagnosis in patients with cancer who have fever, abdominal pain, and hematuria.
两名血液系统恶性疾病（多发性骨髓瘤和原发性骨髓化生）患者出现发热、腹痛和血尿。分别发现每名患者患有气肿性膀胱炎（EC），继发于产气荚膜梭菌和白色念珠菌。两名患者均有身体衰弱的基础疾病、免疫功能受损、既往使用过广谱抗生素和皮质类固醇、膀胱出口梗阻以及留置Foley导管，这些均为发生EC的易感因素。两人均非糖尿病患者。
这些病例为回顾关于这一罕见疾病的病理生理学和治疗的相关医学文献提供了机会。
治疗包括控制潜在的糖尿病（如果存在）、给予适当的抗生素、建立尿液引流、提供支持性的综合医疗护理、排除膀胱瘘的存在，以及仅在不可避免时进行手术清创。
EC应成为患有发热、腹痛和血尿的癌症患者鉴别诊断的一部分。
