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BMJ Case Reports 2017; doi:10.1136/bcr-2017-219594

Unusual association of emphysematous cystitis and chronic alcoholism

  1. Durga Bodala2
  1. 1Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
  2. 2Monmouth Medical Center, Long Branch, New Jersey, USA
  1. Correspondence to Dr Aasems Jacob, aasemsj{at}gmail.com
  • Accepted 3 March 2017
  • Published 16 March 2017

Description

A Caucasian woman aged 65 years with a history of chronic alcoholism presented to the hospital with confusion. Abdominal examination revealed lower abdominal tenderness with no guarding or rigidity. Ethanol level was 378 mg/dL (<10 mg/dL: absent; >300 mg/dL: potentially fatal level) and blood counts in low normal range. Lactic acid was elevated to 3.6 mmol/L and urinalysis revealed pyuria, haematuria, 4+bacteria and positive leucocyte esterase. CT scan of the abdomen showed air within the bladder wall without urinary calculus or obstruction (figures 1 and 2). Patient's mental status improved with intravenous hydration and ertapenem. Urine culture showed heavy growth of …

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