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气肿性膀胱炎,一种严重的尿路感染:一例手术病例报告。

Emphysematous cystitis, a serious urinary tract infection: A surgery case report.

作者信息

Ouskri Salim, Ibrahimi Ahmed, Zaoui Youssef, Boualaoui Imad, El Sayegh Hachem, Nouini Yassine

机构信息

IBN sina universitary hospital, Morocco.

IBN sina universitary hospital, Morocco.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110442. doi: 10.1016/j.ijscr.2024.110442. Epub 2024 Oct 16.

Abstract

INTRODUCTION AND IMPORTANCE

Emphysematous cystitis is a rare and serious urinary tract infection with gas in the bladder, commonly affecting elderly diabetic women. Prompt evaluation and management are vital due to its potential life-threatening nature, associated with risk factors like diabetes, neurogenic bladders, and urinary stasis.

CASE PRESENTATION

A 55-year-old woman with type 1 diabetes presented confusion, lumbar pain, and urinary symptoms. Elevated CRP, white blood cells and imaging revealed extensive emphysema. Urinary drainage and empirical antibiotics (Ceftriaxone, metronidazole, amikacin) targeting Klebsiella pneumoniae led to clinical improvement. A 14-day treatment was followed by referral to an endocrinologist for diabetes management.

DISCUSSION

Emphysematous cystitis, often linked to poorly controlled diabetes, presents diverse symptoms. Diagnosis relies on imaging, with computed tomography being the gold standard. Symptoms range from asymptomatic to severe, necessitating prompt intervention and tailored antibiotic therapy. Successful treatment involves addressing risk factors, emphasizing glycemic control.

CONCLUSION

Emphysematous cystitis demands prompt attention, considering its rarity and potential severity. Timely diagnosis and comprehensive management are crucial for a favorable prognosis, highlighting the need for swift physician intervention.

摘要

引言与重要性

气肿性膀胱炎是一种罕见且严重的膀胱内有气体的尿路感染,常见于老年糖尿病女性。由于其潜在的危及生命的性质,以及与糖尿病、神经源性膀胱和尿潴留等危险因素相关,及时评估和处理至关重要。

病例介绍

一名55岁的1型糖尿病女性出现意识模糊、腰痛和泌尿系统症状。CRP、白细胞升高以及影像学检查显示广泛的气肿。尿液引流以及针对肺炎克雷伯菌的经验性抗生素治疗(头孢曲松、甲硝唑、阿米卡星)使临床症状得到改善。在进行了14天的治疗后,患者被转诊至内分泌科进行糖尿病管理。

讨论

气肿性膀胱炎通常与糖尿病控制不佳有关,症状多样。诊断依赖于影像学检查,计算机断层扫描是金标准。症状从无症状到严重不等,需要及时干预和定制化的抗生素治疗。成功的治疗包括解决危险因素,强调血糖控制。

结论

考虑到气肿性膀胱炎的罕见性和潜在严重性,需要及时关注。及时诊断和综合管理对于良好的预后至关重要,凸显了医生迅速干预的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/11532892/9e64d608f302/gr1.jpg

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