Emphysematous cystitis is a rare but severe lower urinary tract infection characterized by the accumulation of gas in and around the bladder wall produced by bacterial or fungal fermentation. It is more common among elderly, diabetic and female patients.

Aim:

We present a case of Acute emphysematous cystitis in a diabetic patient with a poor glycemic control and we discuss diagnostics and treatment aspects of this rare and uncommon serious infection which may be fatal if left untreated.

Methods and Results :

A 65 year old female presented to the casualty with complaints of abdominal pain with high grade fever for past one week. Clinical examination revealed tenderness in bilateral lumbar and suprapubic region, ultrasonography showed bilateral renal calculi and CT abdomen revealed multiple air pockets in the anterior wall of the gall bladder associated with air pockets in the bilateral renal calyces suggestive of emphysematous cystitis. Antibiotics started and patients improved clinically.

Conclusion:

Emphysematous cystitis is a rare form of UTI characterized by the presence of gas within the bladder wall and/or lumen1. It has been suggested that ultrasonography is the more sensitive technique for detection of gas within the bladder at an early stage2. Emphysematous cystitis requires aggressive treatment with parentral antibiotics .