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Clinical Images  |   November 2011
Emphysematous Cystitis
Author Notes
  • From the Department of Urology at Charleston Area Medical Center in West Virginia 
  • Address correspondence to Nathan E. Hale, DO, Department of Urology, Charleston Area Medical Center, 3110 MacCorkle Ave SE, Room 58, Charleston, WV 25304-1210. E-mail: nhale@camc.org  
Article Information
Imaging / Urological Disorders / Clinical Images
Clinical Images   |   November 2011
Emphysematous Cystitis
The Journal of the American Osteopathic Association, November 2011, Vol. 111, 645. doi:10.7556/jaoa.2011.111.11.645
The Journal of the American Osteopathic Association, November 2011, Vol. 111, 645. doi:10.7556/jaoa.2011.111.11.645
A 77-year-old white woman presented with the chief complaint of constipation. She reported 1 week of urinary frequency, urgency, and dysuria before constipation developed. The patient denied any fever, chills, nausea, or vomiting. Her past medical history was significant for hypertension; she had no history of diabetes mellitus. Physical examination revealed some mild suprapubic tenderness, but findings were otherwise normal. The serum white blood cell count was 14,200/μL. Her serum glucose was 82 mg/dL. An abdominal radiograph demonstrated curvilinear areas of radiolucency of the bladder wall (arrow). Urinalysis was positive for nitrite and leukocyte esterase with 85 white blood cells per high-power field. Urine culture was positive for Escherichia coli, the most commonly identified organism for emphysematous cystitis. The patient was treated with piperacillin/tazobactam administered intravenously, 3.375 g every 6 hours for 4 days, followed by oral cepha lexin, 500 mg every 12 hours for 10 days. Clinical and radiologic improvement was observed. 
   Financial Disclosures: None reported.
 
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Reference
Reference
Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphysematous cystitis: a review of 135 cases [published online ahead of print May 17, 2007]. BJU Int. 2007;100(1):17-20. [CrossRef] [PubMed]