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A 61-year-old woman with abdominal pain and urination disorders
Authors:Picardi A  Manfrini S  Navajas F  De Iorio F  Amicarelli E  Spoto S  Meloni M C  De Galasso L  Vespasiani Gentilucci U  Scarlata S  Costantino S
Abstract:The case of a 61 yo diabetic woman presenting with dysuria and lower abdominal pain is described. The incomplete resolution of the clinical picture after short antibiotic treatment and a strong suspect of autonomic neuropathy oriented to an anamnestic reevaluation that evidenced the presence of pneumaturia. The last was the key-symptom that guided to diagnostic imaging showing emphysematous cystitis while a gastroscopy confirmed the presence of autonomic neuropathy manifested by gastroparesis. Emphisematous cystitis is a characteristic infectious complication of diabetic patients induced by a persistent incomplete bladder emptying and bacterial glucose fermentation. The complete eradication of the infectious agent requires a long term antibiotic course and a prompt identification of this pathology.
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