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气肿性膀胱炎:病例报告及文献综述

Emphysematous Cystitis: A Case Report and Literature Review.

作者信息

González Flores José Emiliano, Melin Herrera Oscar, Urbina Velázquez Marco A, Sandoval Polito Alfonso, Cortés Juárez Tania S, Escobar Gómez Carlos E

机构信息

Medicine, Instituto Tecnológico y de Estudios Superiores de Monterrey (ITESM) Campus Ciudad de México, Mexico City, MEX.

General Practice, Hospital General de Zona #36 Instituto Mexicano del Seguro Social (IMSS), Pachuca City, MEX.

出版信息

Cureus. 2025 May 2;17(5):e83351. doi: 10.7759/cureus.83351. eCollection 2025 May.

Abstract

Urinary tract infections (UTIs) are one of the most common infectious diseases worldwide, predominantly affecting women due to anatomical factors. Among UTIs, emphysematous cystitis (EC) is a rare but clinically significant entity characterized by gas presence in the bladder wall or lumen, often caused by gram-negative bacteria like  and . Diagnosis is challenging due to nonspecific symptoms such as dysuria, abdominal pain, and occasionally pneumaturia, with computed tomography being the diagnostic method of choice. We report the case of a 65-year-old male with diabetes and a significant surgical history, who was admitted for abdominal pain and nausea due to an intestinal obstruction. Incidental findings on computed tomography revealed EC, necessitating antimicrobial therapy adjustment. The patient was successfully managed conservatively with meropenem, glycemic control, and surgical follow-up for associated hernia complications. This case emphasizes the importance of the early recognition and multidisciplinary management of EC, particularly in high-risk patients like diabetics. Timely imaging and targeted antibiotic therapy are crucial for reducing complications and improving outcomes in such complex clinical scenarios.

摘要

尿路感染(UTIs)是全球最常见的传染病之一,由于解剖学因素,主要影响女性。在尿路感染中,气肿性膀胱炎(EC)是一种罕见但具有临床意义的病症,其特征是膀胱壁或腔内存在气体,通常由革兰氏阴性菌如[具体细菌名称缺失]引起。由于尿痛、腹痛以及偶尔出现的气尿等非特异性症状,诊断具有挑战性,计算机断层扫描是首选的诊断方法。我们报告了一例65岁男性病例,该患者患有糖尿病且有重大手术史,因肠梗阻导致腹痛和恶心入院。计算机断层扫描的偶然发现显示为气肿性膀胱炎,需要调整抗菌治疗。患者通过美罗培南、血糖控制以及对相关疝并发症的手术随访成功进行了保守治疗。该病例强调了早期识别和气肿性膀胱炎多学科管理的重要性,特别是在糖尿病等高危患者中。及时的影像学检查和针对性抗生素治疗对于在这种复杂临床情况下减少并发症和改善预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe13/12126998/b831432de2a4/cureus-0017-00000083351-i01.jpg

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