Emphysematous cystitis is a rare infection of the urinary system that produces gas production in the bladder, and can be considered a complicated urinary tract infection. This is because there is a production of yeast and bacteria that develops in the urinary tract that causes this urinary infection, and it is mostly diagnosed in diabetic middle aged women than in men (Eken, 2013). The disease has no diagnostic clues, and can be noticed by the presence of air in imaging studies. This disease can be potentially fatal if it is not taken care of, and there are many factors that can derive this disease, however, with proper care it can be taken care of on time before it is too late.
About two thirds of this disease is caused by E.coli, and the other third is caused by Enterbacter, Clostridium, Staphylococcus aureus species (Eken, 2013). E. coli usually lives in the gut, however, when feces shed it causes the bacteria to spread to an opening of the urinary tract and the bladder causing problems (Bhandari, 2017). A patient with this usually has dysuria, hematuria, abdominal pain, urinary urgency, and small presence of air bubbles called pneumaturia (Alma, 2013).
There was a rare case, in which, they could not find out what the 49 year old female, had type two diabetes and was in the emergency room for urinary frequency and pneumaturia for several weeks. They had to take laboratory tests because it was unknown of what it was that she had, and the tests did reveal abnormal results as there was a lot of bacteria in urine; however it was found that she had hyperglycemia, and she was not diagnosed with this disease until she did computed tomography to find the gas in the bladder wall (Nelson, 2021).
This can be diagnosed, by looking at through radiography, and it can be difficult to look at pneumaturia, especially in diabetic patients. This is because "carbon is produced through fermentation due to the glucose concentrations being high, however in non-diabetics it is seen that the tissue proteins and urinary lactulose that serve as substrates increase the pressure of the pneumaturia" (Alma, 2013). This rare urinary disease can lead to other problems like Crohn's disease or carcinoma of the colon or bladder, and if not treated with antibiotics can lead to death. As the overall death rate of people with this disease is 22.9% (Chen, etc, 2023). Even though this disease is rare in the urinary system, it allows us to be better informed about diseases that have death rates, as it serves as a learning experience to learn about diseases that are very rare in the healthcare field.
Work Cited
Bhandari, T. (2018, December 27). UTI treatment reduces E. coli, and may offer alternatives to antibiotics. Washington University School of Medicine in St. Louis. https://medicine.wustl.edu/news/uti-treatment-lowers-numbers-gut-e-coli-may-offer-alternative-antibiotics/#:~:text=become%20life%2d Threatening.-,Most%20UTIs%20are%20 used%20by%20E.,where%20they%20can%20cause%20problems.
Chen, Y.-H., Hsieh, M.-S., Hu, S.-Y., Huang, S.-C., Tsai, C.-A., & Tsai, Y.-C. (2023, February 13). Scoring systems to evaluate the mortality risk of patients with emphysematous cystitis: A retrospective observational study. MDPI. https://www.mdpi.com/2075-4426/13/2/318#:~:text=Several%20studies%20had%20 reported%20the,%25%20%5B2%2C3%5D.
Eken, A., & Alma, E. (2013). Emphysematous cystitis: The role of CT imaging and appropriate treatment. Canadian Urological Association journal = Journal de l’Association des urologues du Canada. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840514/#:~:text=Emphysematous%20cystitis%20is%20a%20relatively,diabetic%20patients%20with%20unusual%20presentations.
Emphysematous cystitis - mayo clinic proceedings. (n.d.). https://www.mayoclinicproceedings.org/article/S0025-6196(21)00186-5/fulltext
Hello Fernanda!
ReplyDeleteThis is very interesting to read. I have not heard of this disease before. Since it is essential for the diagnosis to happen quickly for this disease, I think we can consider the risk factors that are often associated with this disease in order to make a quicker diagnosis. Like you said, and according to this paper (Kelesidis, 2021), emphysematous cystitis (EC) happens majority in middle age women, and also in populations of patients who experience immunosuppression, diabetes mellitus and have had previous UTIs before. When this population came in, it is important for physicians to consider EC to be able to make a quicker diagnosis when there are lack of diagnostic clues.
Kelesidis, T., Osman, S., & Tsiodras, S. (2009). Emphysematous cystitis in the absence of known risk factors: an unusual clinical entity. Southern medical journal, 102(9), 942–946. https://doi.org/10.1097/SMJ.0b013e3181adf18c