A Case of Emphysematous Cystitis

DOI
  • SASAHASHI Nozomu
    National Hospital Organization, Kyoto Medical Center, Department of Emergency and Critical Care Medicine
  • KANEKO Ichiro
    National Hospital Organization, Kyoto Medical Center, Department of Emergency and Critical Care Medicine
  • OBATA Kaoru
    National Hospital Organization, Utano Hospital, Depatment of Neurology
  • BEPPU Satoru
    National Hospital Organization, Kyoto Medical Center, Department of Emergency and Critical Care Medicine
  • NAKANO Ryota
    National Hospital Organization, Kyoto Medical Center, Department of Emergency and Critical Care Medicine
  • HAMANAKA Kunio
    National Hospital Organization, Kyoto Medical Center, Department of Emergency and Critical Care Medicine
  • YOSHIDA Kosuke
    National Hospital Organization, Kyoto Medical Center, Department of Emergency and Critical Care Medicine
  • INOUE Kyo
    National Hospital Organization, Kyoto Medical Center, Department of Emergency and Critical Care Medicine
  • MASUDA Norihiko
    National Hospital Organizaion, Kyoto Medical Center, Department of Urology
  • OKUNO Hiroshi
    National Hospital Organizaion, Kyoto Medical Center, Department of Urology

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  • 気腫性膀胱炎の1例

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<p>症例：82歳の女性。以前より頻尿の傾向があった。2011年3月，排尿障害と腹部膨満を主訴に近医受診，CTにて気腫性膀胱炎を疑われ当院に紹介された。来院時体温37.6℃，WBC 18,700/mm3，CRP 23.04 mg/dl，尿検査で細菌3＋，白血球，赤血球を多数認め，肉眼的に黒色～暗赤色を呈していた。腹部造影CTでは膀胱壁内，膀胱内腔にair像，腸管のガス貯留を認め，気腫性膀胱炎に一致する所見であった。尿培養より，Streptococcus sp.ならびにClostridium perfringensが検出された。入院後，抗菌薬の投与により次第に症状軽快し，第13病日紹介医に転院した。気腫性膀胱炎は，ガス産生菌が膀胱内に貯留するまれな疾患で，抗菌剤により軽快することが多いが，まれに敗血症などにより重症化することがあり，注意が必要である。</p>

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