Picture Diagnosis

Q; 32 years old female with history of brittle diabetes is admitted to ICU with lower abdominal pain and probable diagnosis of urosepsis. KUB is below?

Diagnosis: Emphysematous cystitis 

Emphysematous cystitis is a rare entity characterized by pockets of gas in and around the bladder wall produced by bacterial or fungal fermentation. Risk factors include female sex, immunocompromised state, diabetes mellitus, recurrent urinary tract infections, neurogenic bladder and few others. It is less lethal than emphysematous pyelonephritis and rarely needs surgical intervention. Treatment is via appropriate antibiotic therapy.

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Reference:

Amano M, Shimizu T. Emphysematous cystitis: a review of the literature. Intern Med. 2014;53(2):79-82. doi: 10.2169/internalmedicine.53.1121. Epub 2012 Mar 1. PMID: 24429444.