Yoshino Tateki, Ohara Shinya, Moriyama Hiroyuki
Department of Urology, JA Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima 722-0018, Japan.
Case Rep Urol. 2013;2013:821780. doi: 10.1155/2013/821780. Epub 2013 Jul 10.
Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients, which was characterized by air within the bladder wall and lumen. A 83-year-old woman was introduced to our department with fever elevation and abnormal findings of computed tomography (CT). She took orally prednisolone for autoimmune hepatitis. Pelvic CT revealed diffuse air throughout the bladder wall. Urinalysis showed combined hematuria and pyuria. Escherichia coli was detected in blood culture. Abnormal findings of complete blood count and laboratory examination included an elevated WBC count (12,200/μL), C-reactive protein (11.7 mg/dL), and creatinine (1.07 mg/dL). Cystoscopy confirmed diffuse submucosal emphysema throughout. On the basis of diagnosis with emphysematous cystitis, she was treated with antibiotics based on the results of blood culture and indwelling Foley catheter. After treatment, the improvement of inflammatory findings and submucosal emphysema on cystoscopy and CT were achieved.
气肿性膀胱炎是一种临床罕见的病症，多见于糖尿病患者及免疫功能低下者，其特征为膀胱壁和腔内有气体。一名83岁女性因发热及计算机断层扫描（CT）检查异常被收入我科。她因自身免疫性肝炎口服泼尼松龙。盆腔CT显示膀胱壁弥漫性积气。尿液分析显示血尿和脓尿并存。血培养检测到大肠杆菌。全血细胞计数及实验室检查的异常结果包括白细胞计数升高（12,200/μL）、C反应蛋白升高（11.7mg/dL）及肌酐升高（1.07mg/dL）。膀胱镜检查证实全膀胱弥漫性黏膜下气肿。基于气肿性膀胱炎的诊断，根据血培养结果给予抗生素治疗并留置Foley导尿管。治疗后，膀胱镜检查及CT显示炎症表现及黏膜下气肿有所改善。
