Emphysematous Cystitis and Septic Shock: A Multidisciplinary Approach to Managing a Life-Threatening Urological Infection

Abstract

Emphysematous cystitis (EC) is a rare, life-threatening urinary tract infection (UTI) characterized by gas formation within the bladder wall and lumen. It predominantly occurs in patients with poorly controlled diabetes. We present a case of a 61-year-old male with poorly controlled diabetes and chronic alcoholism who was admitted in a comatose state due to severe septic shock secondary to EC. Initial management included mechanical ventilation, vasopressor support, and broad-spectrum antibiotics. Cultures revealed Klebsiella pneumoniae resistant to the initial therapy, prompting a switch to Meropenem. With prompt multidisciplinary intervention, the patient gradually recovered, was successfully extubated, and was transferred from the ICU by day 5. He was discharged from the hospital on day 17 with full clinical recovery. This case highlights the critical role of early diagnosis, appropriate antimicrobial therapy, and intensive supportive care in managing severe cases of EC with multiorgan failure.