Frazão Teresa, Brito Ana Patrícia, Cerdeira Frazão Joana, Cotter Jorge
Internal Medicine, Unidade Local de Saúde do Alto Ave, Guimarães, PRT.
Internal Medicine, Hospital Senhora da Oliveira, Guimarães, PRT.
Cureus. 2024 Nov 14;16(11):e73685. doi: 10.7759/cureus.73685. eCollection 2024 Nov.
Emphysematous cystitis (EC) is a rare, life-threatening urinary tract infection (UTI) characterized by gas formation within the bladder wall and lumen. It predominantly occurs in patients with poorly controlled diabetes. We present a case of a 61-year-old male with poorly controlled diabetes and chronic alcoholism who was admitted in a comatose state due to severe septic shock secondary to EC. Initial management included mechanical ventilation, vasopressor support, and broad-spectrum antibiotics. Cultures revealed resistant to the initial therapy, prompting a switch to Meropenem. With prompt multidisciplinary intervention, the patient gradually recovered, was successfully extubated, and was transferred from the ICU by day 5. He was discharged from the hospital on day 17 with full clinical recovery. This case highlights the critical role of early diagnosis, appropriate antimicrobial therapy, and intensive supportive care in managing severe cases of EC with multiorgan failure.
气肿性膀胱炎（EC）是一种罕见的、危及生命的尿路感染（UTI），其特征是膀胱壁和腔内形成气体。它主要发生在糖尿病控制不佳的患者中。我们报告一例61岁男性病例，该患者糖尿病控制不佳且患有慢性酒精中毒，因气肿性膀胱炎继发严重感染性休克而昏迷入院。初始治疗包括机械通气、血管活性药物支持和广谱抗生素。培养结果显示对初始治疗耐药，促使改用美罗培南。通过及时的多学科干预，患者逐渐康复，成功脱机，并在第5天从重症监护病房转出。他于第17天临床完全康复出院。该病例突出了早期诊断、适当的抗菌治疗和强化支持治疗在管理伴有多器官功能衰竭的严重气肿性膀胱炎病例中的关键作用。
