Karima Sif Nasr, Rayane Bekkaoui, Abir El hamzi, Ola Messaoud, Zaynab Iraqi Houssaini, Laila Jroundi, Omar El Aoufir
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 10
Date of Publication: 2026/10/25
Gas-forming infections of the urinary tract are uncommon but potentially life-threatening, and they occur almost exclusively in patients with diabetes mellitus. Concomitant emphysematous cystitis and emphysematous pyelonephritis is rare, and contiguous extension of the infection to the prostate and to the pelvic spaces is rarer still. We report a 55-year-old man with untreated type 2 diabetes mellitus admitted with sepsis of urinary origin, in whom contrast-enhanced computed tomography showed gas within a thickened bladder wall, gas in the right renal collecting system with bilateral non-enhancing parenchymal foci and perinephric fat stranding, two communicating prostatic collections, and a gas-containing Douglas-pouch collection measuring 70 × 32 mm, corresponding to Huang–Tseng class II. This case highlights that a single gas-forming infection can involve the bladder, both kidneys, the prostate and the pelvic spaces simultaneously, and that gas anywhere along the urinary tract on computed tomography in a septic patient with diabetes is an indication for urgent source control rather than antibiotics alone.
Emphysematous cystitis; Emphysematous pyelonephritis; Emphysematous urinary tract infection; Diabetes mellitus; CT imaging; Prostatic abscess.
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