Emphysematous Bladder Infection: Symptoms, Treatments, and Further Details
Emphysematous Cystitis: A Rare but Potentially Life-Threatening Urinary Tract Infection
Emphysematous cystitis (EC) is a rare type of urinary tract infection (UTI) that can pose serious health risks if left untreated. This condition, which is characterised by a buildup of gas in and around the bladder wall, affects a higher number of individuals over the age of 60 years [1].
The most common risk factor for EC is diabetes mellitus, with more than half of individuals with EC also having diabetes [1]. Other risk factors include a weakened immune system, structural or functional abnormalities of the urinary tract, and having an indwelling urethral catheter [1]. Additionally, individuals with a chronic urinary tract infection are at a higher risk of developing EC [1].
Diabetes mellitus poses a significant risk because high glucose levels can promote gas-forming bacterial infections in the bladder wall [2]. Immunosuppression, which lowers the body's ability to fight infections, and structural or functional urinary tract abnormalities (such as obstruction, catheterization, or neurogenic bladder) also contribute to the risk of EC [2].
Early diagnosis of EC is essential for timely treatment. However, EC is frequently undiagnosed due to nonspecific signs and symptoms [1]. Doctors diagnose close to 80% of EC cases using X-rays [1]. Imaging tests, such as ultrasounds, X-rays, and CT scans, help doctors rule out other possible causes of abdominal pain and look for the presence of air in the urinary tract and around the bladder [1].
Treatment for EC usually lasts 4 weeks, but the duration depends on the infection severity, the person's medical history, and any complications [1]. Doctors treat EC with antibiotics, typically starting with broad-spectrum antibiotics and prescribing specific antibiotics once the lab results confirm the type of pathogen [1].
Untreated EC can lead to a life-threatening kidney infection called emphysematous pyelonephritis, increasing a person's risk of septic shock, bladder rupture, and death [1]. Therefore, it is crucial to seek medical attention promptly if experiencing symptoms such as frequent urination, pain or burning during urination, fever, or abdominal pain [1].
The primary causative organisms commonly implicated in EC include Escherichia coli and other gas-forming bacteria [2]. A urinalysis can help doctors look for the presence of hematuria (blood in the urine), pyuria (white blood cells or pus in the urine), bacteriuria (bacteria in the urine), and glucose (sugar in the urine) [1].
In conclusion, elderly diabetic patients with compromised immune systems or pre-existing urinary tract abnormalities are at heightened risk of developing emphysematous cystitis. It is essential to be aware of the signs and symptoms of this condition and seek medical attention promptly to prevent serious adverse outcomes.
References: [1] NIDDK. (2021). Emphysematous cystitis. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/emphysematous-cystitis [2] UpToDate. (2021). Emphysematous cystitis. UpToDate. Retrieved from https://www.uptodate.com/contents/emphysematous-cystitis
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