A Life-threatening Case of Emphysematous Cystitis with Large Bladder Stones

Abstract

Emphysematous cystitis is a life-threatening condition that can arise from complicated urinary tract infections. It is especially common in patients with poorly controlled diabetes mellitus. Common pathogens associated with this entity include E. coli, K. pneumoniae, P. mirabilis, among others. We present a case of a 69-year-old male with underlying benign prostatic hyperplasia and type II diabetes mellitus presenting with left-sided flank pain, nausea, gross hematuria, nausea, and vomiting. Computer tomography of the abdomen and pelvis revealed two large bladder stones (up to 4.5cm), trace intraluminal air in the bladder, and an enlarged prostate. Urine cultures grew Extended-Spectrum Beta-Lactamase (ESBL) E. coli, and the patient was treated with Ertapenem and management of underlying comorbidities. The patient was discharged after overall clinical status improvement.