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Emphysematous Cystitis Combined with Prostatic Abscess and Hematogenous Spread of Infection to the Lung and Liver in a Diabetic Patient
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Jangwon Lee, Harin Rhee, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Sang Heon Song
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Urogenit Tract Infect 2017;12(3):130-133. Published online December 31, 2017
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 Abstract
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- Coexistence of emphysematous cystitis and prostatic abscess are rare occurrences. Here, we report a case of emphysematous cystitis and prostatic abscess in a 65-year-old man with a 5-year history of diabetes mellitus. This case was further complicated by the hematogenous spread of Klebsiella pneumoniae infection from the prostatic abscess to the liver and lung. Computed tomography (CT) imaging revealed a localized gas within the urinary bladder and swelling of the prostate, with fluid accumulation. Multiple low-density lesions were observed in liver segments S3, S4, and S7, suggestive of an inflammatory process. Chest CT scan revealed multiple cavitatory nodules of various sizes, with a ground glass appearance of both lung fields, which suggest septic emboli from severe uro-septicemia. The optimal antibiotic therapy was administered, and a holmium laser enucleation of the prostate operation was subsequently performed. On day 37 post-admission, the patient was discharged in a good condition, without any sequelae.
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