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July 24, 1981

Emphysematous Cystitis due to Clostridium perfringens

Author Affiliations

From the Division of Infectious Diseases (Drs West and Holley) and the Department of Medicine (Drs Holley and Lauer), Medical University of South Carolina, and the Department of Medicine, Veterans Administration Hospital (Dr West), Charleston, SC.

JAMA. 1981;246(4):363-364. doi:10.1001/jama.1981.03320040035026

ANAEROBIC bacteria are infrequent pathogens of the urinary tract. Emphysematous cystitis results most commonly from infection with a gasforming aerobic organism such as Escherichia coli.1 We describe a diabetic patient with emphysematous cystitis due to the gas-forming anaerobe Clostridium perfringens.

Report of a Case  A 72-year-old woman was admitted to the Charleston County Hospital in December 1979 for evaluation of weakness and intermittent, cramping, periumbilical pain of two months' duration. She reported that the pain decreased after voiding and denied any dysuria, urgency, urinary incontinence, or pneumaturia. She was a well-controlled diabetic whose condition was maintained with 20 units of isophane insulin suspension daily. Blood glucose value on admission was 86 mg/dL; hematocrit reading, 31 vol%; and WBC count, 7,700 cells per cubic millimeter, with 41% neutrophils. Findings from urinalysis demonstrated 35 to 45 WBCs per cubic millimeter and were otherwise normal. An abdominal roentgenogram showed an enlarged bladder