Abstract
The case of a 55-year-old diabetic woman with pneumaturia due to gas production in the bladder is presented. She was admitted to the hospital because of pneumaturia, macrohematuria and fever. Diabetes mellitus had been diagnosed at the age of 41, and she had been taking insulin ever since. Her blood levels were poorly controlled. On admission she had proliferative retinopathy, severe diabetic neuropathy and nephropathy. Plain abdominal film and CT scan showed gaseous shadow in the bladder. A postvoiding urethral catheterization yielded 550 ml of cloudy urine followed by gas. The intravenous administration of ampicillin resulted in marked improvement in clinical status. To our knowledge, 8 cases of emphysematous cystitis have been reported in the Japanese literature, and the clinical features of these cases are reviewed. Emphysematous cystitis occurs with increased frequency in patients with diabetes and must be taken into consideration, especially in older diabetics with macrohematuria.
