Emphysematous Cystitis: Mortality, Risk Factors, and Pathogens of a Rare Disease

Abstract

Although high mortality rates have been reported for emphysematous pyelonephritis (EP), information on emphysematous cystitis (EC), which is less common, is sparse. Here, we report one new case of severe EC and 136 cases of EC that occurred between 2007 and 2016, and review information about the characteristics, diagnosis, treatment and mortality of these patients, and the pathogens found in these patients. The mean age of the 136 patients was 67.9±14.2 years. Concurrent emphysematous infections of other organs were found in 21 patients (15.4%), with emphysematous pyelonephritis being the most common of these infections. The primary pathogen identified was Escherichia coli (54.4%). Patients were mainly treated by conservative management that included antibiotics (n=105; 77.2%). Ten of the 136 patients with EC died, yielding a mortality rate of 7.4%. Despite the relatively low mortality rate of EC compared with that of EP, a high degree of suspicion must be maintained to facilitate successful and conservative management.

Keywords: Pathogens; emphysematous cystitis; mortality; urinary tract infection.

Figure 1.

Contrast-enhanced computed tomography of the abdomen: A) emphyesematous cystitis involving the perirectal space; B) emphysematous cystitis with accompanying absceding prostatitis.