Öz
Introduction
This study describes the clinical course of a patient with type 2 DM and obesity who was diagnosed with a rare EC; early and effective treatment prevented the development of sepsis and mortality.
Case Report
A 52-year-old female patient presented to the emergency department with complaints of fever and pain in the inguinal region. The patient patient had known hypertension, DM, and obesity. A physical examination revealed tenderness and defense in the right and left lower quadrants of the abdomen. Other system examinations were normal. Laboratory analyses revealed the following: CRP (C-reactive protein) 439 mg/dl, glucose 343 mg/dl, urea 95.9 mg/dl, creatinine 2.11 mg/dl; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values were within normal limits. In the abdominal CT, air density was observed in the bladder lumen. She was admitted to the infectious diseases clinic with a preliminary diagnosis of urinary system infection. Hydration therapy was continued. Piperacillin tazobactam and ceftriaxone treatment was started. The patient was discharged with recommendations on the 12th day of hospitalization.
Conclusion
When evaluating urinary system infections in diabetic patients, EC should be included in the differential diagnosis. With hospitalization and effective treatment, the disease can be treated before it progresses to sepsis.
Anahtar Kelimeler
Emphysematous cystitis, urinary system infection diabetes mellitus
Kaynakça
- Nokay M, Oğul L, Çıra DK et al. Emphysematous Cystitis: A Rare Cause of Abdominal Pain. Akd Med J. 2020; 6(2): 314-316.
- Choi J, Choi S-K, Lee S-H et al. Clinical Outcomes and Risk Factor Analysis of Patients Presenting with Emphysematous Cystitis: A 15-Year Retrospective Multicenter Study. Medicina. 2021; 57(6):531. https://doi.org/10.3390/medicina57060531.
- Okada S, Ichimura Y, Linuma M. Emphysematous cystitis due to Streptococcus salivarius infection in a patient with a neurogenic bladder. IDCases. 2022;27: e01410. https://doi.org/:10.1016/j.idcr.2022.e01410.
- Grupper M, Kravtsov A, Potasman I. Emphysematous cystitis: Illustrative case report and review of the literature. Medicine (Baltimore) 2007; 86(1):47-53. https://doi.org/10.1097/MD.0b013e3180307c3a.
- Noda R, Nishinarita J, Araki K et al. Emphysematous Cystitis Caused by Dysuria due to Sulpiride in a Patient with Chronic Kidney Disease: a Case Report. SN Compr. Clin. Med. 2022;4:97. https://doi.org/s42399-022-01180-7.
- Obeidat N, Al-Omari MH, Shwayyat B. Showering gas bubbles within the inferior vena cava detected sonographically can unmask a hidden infection: a case report of a rare presentation in a patient with emphysematous cystitis. J Ultrasound (2022). (Ahead of print). https//doi.org/10.1007/s40477-022-00673-4.
- Tsakaldimis G, Bousiou Z, Dimou-Besikli S et al. Pneumomediastinum as a rare complication in an immunosuppressed patient with emphysematous cystitis. Clin Case Rep. 2022; 10(2):e05429. https://doi.org/10.1002/ccr3.5429.
- Yıldız H. Coexistence of Rare Emphysematous Pyelonephritis and Cystitis in Uncontrolled Diabetes Mellitus Case: Case Report and Literature Review. KSÜ Med Fac. Journal. 2019;14(2): 85-88.
Öz
Amaç
Tip 2 DM ve obezitesi olan ve nadir görülen amfizematöz sistit tanısı alan hastanın klinik seyrini anlatmak ve bu sayede erken taburculuğun önlenerek, etkin tedavi ile sepsis gelişimini ve mortaliyteyi engellemek amaçlanmıştır.
Olgu Sunumu
52 yaşında kadın hasta, kasıkta ağrı ve ateş şikayeti ile acil servise başvurdu. Bilinen Hipertansiyon, diyabetes mellitus ve obezite hastalıkları mevcuttıu. Fizik muayenede batında sağ ve sol alt kadranda hassasiyet ve defans mevcuttu. Diğer sistem muayeneleri normal idi. Labaratuvar tetkiklerinde CRP( c reaktif protein):439 mg/dl, glukoz:343 mg/dl, üre:95,9 mg/dl, kreatinin:2,11 mg/dl olup olup ALT(alanin aminotransferaz) ve AST(aspartat aminotransferaz) değerleri normal sınırlarda idi. Batın BT’de mesane lümeninde hava dansitesi izlendi. Üriner sistem enfeksiyonu ön tanısı ile enfeksiyon hastalıkları kliniğine yatırıldı. Hidrasyon tedavisi ile birlikte piperasilin tazobactam ve seftriakson tedavisi başlandı. Yatışının 12. Gününde öneriler ile taburcu edildi.
Sonuç
Diyabetik hastalarda üriner sistem enfeksiyonları değerlendirilirken; amfizematöz sistit ayırıcı tanıda mutlaka yerini almalıdır. Hastane yatışı ve etkin tedavi ile hastalık sepsise ilerlemeden tedavi edilebilmektedir.
Anahtar Kelimeler
Amfizematöz sistit, üriner sistem enfeksiyonu, diyabetes mellitus
Kaynakça
- Nokay M, Oğul L, Çıra DK et al. Emphysematous Cystitis: A Rare Cause of Abdominal Pain. Akd Med J. 2020; 6(2): 314-316.
- Choi J, Choi S-K, Lee S-H et al. Clinical Outcomes and Risk Factor Analysis of Patients Presenting with Emphysematous Cystitis: A 15-Year Retrospective Multicenter Study. Medicina. 2021; 57(6):531. https://doi.org/10.3390/medicina57060531.
- Okada S, Ichimura Y, Linuma M. Emphysematous cystitis due to Streptococcus salivarius infection in a patient with a neurogenic bladder. IDCases. 2022;27: e01410. https://doi.org/:10.1016/j.idcr.2022.e01410.
- Grupper M, Kravtsov A, Potasman I. Emphysematous cystitis: Illustrative case report and review of the literature. Medicine (Baltimore) 2007; 86(1):47-53. https://doi.org/10.1097/MD.0b013e3180307c3a.
- Noda R, Nishinarita J, Araki K et al. Emphysematous Cystitis Caused by Dysuria due to Sulpiride in a Patient with Chronic Kidney Disease: a Case Report. SN Compr. Clin. Med. 2022;4:97. https://doi.org/s42399-022-01180-7.
- Obeidat N, Al-Omari MH, Shwayyat B. Showering gas bubbles within the inferior vena cava detected sonographically can unmask a hidden infection: a case report of a rare presentation in a patient with emphysematous cystitis. J Ultrasound (2022). (Ahead of print). https//doi.org/10.1007/s40477-022-00673-4.
- Tsakaldimis G, Bousiou Z, Dimou-Besikli S et al. Pneumomediastinum as a rare complication in an immunosuppressed patient with emphysematous cystitis. Clin Case Rep. 2022; 10(2):e05429. https://doi.org/10.1002/ccr3.5429.
- Yıldız H. Coexistence of Rare Emphysematous Pyelonephritis and Cystitis in Uncontrolled Diabetes Mellitus Case: Case Report and Literature Review. KSÜ Med Fac. Journal. 2019;14(2): 85-88.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 31 Aralık 2022 |
| Yayımlanma Tarihi | 31 Aralık 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 3 Sayı: 3 - Experimental and Applied Medical Science Vol:3, Issue:3 [en] |
