Caso clínico: cistitis enfisematosa asociada a hidronefrosis secundaria
| Autor: | María Eugenia Sanhueza, Erico Segovia, Rubén Torres, Edith Pérez de Arce Oñate |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Abdominal pain medicine.diagnostic_test business.industry Urinary system Type 2 Diabetes Mellitus Physical examination Hydronephrosis General Medicine medicine.disease Gastroenterology Surgery emphysematous Diabetes mellitus Emphysematous cystitis Internal medicine Cystitis Escherichia coli medicine Ceftriaxone medicine.symptom business medicine.drug |
| Zdroj: | Revista médica de Chile v.142 n.1 2014 SciELO Chile CONICYT Chile instacron:CONICYT |
| ISSN: | 0034-9887 |
| DOI: | 10.4067/s0034-98872014000100018 |
| Popis: | We report a 53 year-old woman with type 2 diabetes mellitus and hypertension, presenting with progressive abdominal pain lasting three weeks, associated with lower abdominal swelling and fever. Clinical examination showed a large increase in abdominal volume, contraction of extracellular compartment, and signs of severe sepsis. Computed tomography showed an over-distended bladder with severe wall and luminal pneumatosis and bilateral hydronephrosis. The diagnosis was of emphysematous cystitis associated to hydronephrosis. Urine and blood cultures were positive for multi-susceptible Escherichia coli. Clinical evolution was favorable after 6 weeks of ceftriaxone and urinary catheter use. Emphysematous cystitis is a rare clinical entity, with an associated mortality of 7%. Known predisposing factors are older age, female gender and presence of diabetes. Microbiological agents most frequently involved are Escherichia coli and Klebsiella pneumoniae (80% of cases). Medical treatment is preferred and is based on urinary tract decompression with a bladder catheter, and prolonged broad spectrum antimicrobial therapy. |
| Databáze: | OpenAIRE |
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