Emphysematous cystitis

Emphysematous cystitis is a rare infection of the bladder wall caused by gas-forming organisms, in which air bubbles form in and around the bladder wall. Escherichia coli is the most common culprit, with Klebsiella and Proteus often found, and fungi such as Candida, Citrobacter and Enterococci also reported. It is the most common of the gas-forming bladder infections. It mostly affects elderly people with diabetes or weakened immune systems, and risk factors include catheter use, repeated urinary tract infections, being female, neurogenic bladder, urinary obstruction and organ transplant. Symptoms range from none at all to abdominal pain, fever, vomiting, confusion, dark or bloody urine, painful or frequent urination and even septic shock, which makes diagnosis slow, and imaging of the abdomen or pelvis is key to confirming it. Cases can progress quickly and be life-threatening. The first case was identified in a post-mortem examination in 1888.