Emphysematous Cystitis along with Emphysematous Pyelonephritis in Type II Diabetes: A Case Report

Emphysematous urinary tract infections (UTIs) are infections of the lower or upper urinary tract associated with gas formation. They may manifest as cystitis, pyelitis, or pyelonephritis. Diabetes mellitus is a major risk factor for these infections. The diagnosis of gas-forming UTI is usually made by plain films of the abdomen and/or computed tomography (CT). Escherichia coli and Klebsiella pneumonia are the predominant etiologic organisms. We present a rare case of emphysematous cystitis along with emphysematous pyelonephritis in a patient with poorly controlled diabetes. This patient underwent nephrectomy and 500 ml of puss was drained before nephrectomy. Puss C/S showed growth of Escherichia coli which was sensitive to pipercillin/tazobactam. We conclude that all female diabetic patients more than 60 years of age presenting with urinary symptoms, abdominal pain, fever and evidence of UTI on urine routine examination should have at-least an ultrasound abdomen and kidney ureter bladder (KUB) done and if presence of air is suspected, these patients should get CT scan KUB done so that diagnosis of emphysematous UTI be made and managed accordingly