A Case of Emphysematous Cystitis with Emphysematous Pyelonephritis

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  • 気腫性腎盂腎炎を合併した気腫性膀胱炎の1例

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Emphysematous cystitis and emphysematous pyelonephritis are relatively rare urinary tract infections with gas collection. It is very rare that both can develop at the same time. We describe a case of emphysematous cystitis occurring together with emphysematous pyelonephritis. A 78-year-old man undergoing stroke rehabilitation in our hospital presented with gross hematuria and fever. As computed tomography revealed a characteristic gas collection in the right renal pelvis and the bladder, we diagnosed emphysematous cystitis with emphysematous pyelonephritis. His condition gradually improved with administration of antibiotics and ureteral catheter drainage. In Japan, there are five reports of emphysematous cystitis with emphysematous pyelonephritis including our case, and all of them were accompanied with hydronephrosis or ureteral dilation. In one case, cystoscopy showed that vesical emphysema occluded the ureteral orifice. Based on these findings, it is supposed that occlusion of the ureteral orifice by vesical emphysema induces hydronephrosis and emphysematous pyelonephritis. The upper urinary tract should therefore be checked in any case of emphysematous cystitis.

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