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Emphysematous cystitis and emphysematous pyelitis: A clinically misleading association

M Ahsaini
Amadou Kassogue
MF Tazi
A Zaougui
JE Elammari
A Khallouk
MJ El Fassi
MH Farih


We present a rare case of emphysematous cystitis associated with an emphysematous pyelonephritis in a diabetic Arab man who was admitted in
a confusional state. A 60-year-old man was admitted to the emergency department with confusion and hypogastric mass. The Clinical examination
found comatose patient with a mass in the tympanic hypogastric percussion. The pelvic computed tomography (CT) demonstrated intramural gas in the urinarytract, which suggested a diagnosis of emphysematous cystitis and emphysematous pyelitis. The treatment was based on an antibiotics  associated with a bladder drainage and diabetes stabilization. The evolution was uneventful. Every diabetic patient with a urinary tract infection who seems to be severely ill should have an abdominal X-ray as a minimal screening tool to detect emphysematous complications. The rarity and the association with an emphysematous pyelitis, which is rarely reported in the literature, are two remarkable characteristics described in this case report.

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eISSN: 1937-8688