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Bladder
Cystitis
Emphysematous cystitis
Author: Nat Pernick, M.D. (see Authors page)
Revised: 20 December 2009, UPDATE IN PROGRESS
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Cystitis due to gas forming bacteria (Clostridium perfringes, E. coli, Enterobacter aerogenes) producing gas filled cysts in bladder wall
● A radiologic finding - usually no surgical specimen
Terminology
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Epidemiology
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● Uncommon; associated with diabetes
Sites
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Etiology
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Clinical features
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● Variable clinical presentation and course
● Clinical symptoms of dysuria, increased urinary frequency, and hematuria are common; also abdominal tenderness
● Associated with diabetes (50% of cases), chronic cystitis, neurogenic bladder, leukemia/lymphoma
● Diagnose with plain films and CT scan (Medicine (Baltimore) 2007;86:47)
● Death rate of 7% (BJU Int 2007;100:17)
Prognostic factors
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Case reports
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● 59 year old woman with abdominal pain (West J Emerg Med 2008;9:171)
● 62 year old woman with diabetes and poor glycemic control (Diabetes Metab 2004;30:377)
Treatment
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● Aggressive treatment with antibiotics to prevent pyelonephritis and urosepsis; must also relieve bladder obstruction
Clinical images
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Radiographs show air in bladder, #1; #2
CT scan shows emphysematous changes in bladder wall, link
CT scan shows thickened bladder wall with pockets of gas, link
Gross description (Macroscopy)
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Gross images
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Micro description (Histopathology)
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● Cysts often lined by multinucleated giant cells
Micro images
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Cytology description
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Cytology images
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Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● (link to topic)
Additional references
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End of Bladder > Cystitis > Emphysematous cystitis
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