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Article
April 1960

Cystitis Emphysematosa: A Review and Report of a Case with Disseminated Inflammatory Emphysema

Author Affiliations

Boston

From the Department of Medicine, St. Vincent Hospital, Worcester, Mass. Senior Assistant Resident in Medicine, Georgetown University Hospital, Washington, D.C.; formerly Intern, St. Vincent Hospital, Worcester, Mass.

AMA Arch Intern Med. 1960;105(4):618-626. doi:10.1001/archinte.1960.00270160116015
Abstract

Cystitis emphysematosa has been defined by Mills as a rare "inflammatory condition of the bladder associated with the presence of gas vesicles in the tissues." 1 It referred strictly to the presence of gas in the vesical wall usually with associated cystitis and hemorrhage. Generalized gas-producing infections with secondary bladder involvement were specifically excluded. No reports of primary bladder lesions with extension to other tissues were available at that time.

The condition has usually been associated with primary infections of the bladder by the coliform group of organisms and the presence of the gas determined incidentally by cystoscopy, x-ray, or at postmortem examination. Intravesical gas, the characteristic manifestation of cystitis emphysematosa, has led to predominant urologic and radiologic interest in this subject.2,3

The present report concerns a fulminating and fatal case in an elderly diabetic woman. It is believed to be the first case of cystitis emphysematosa with generalized

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It must be remembered that pneumaturia from fermentation of bladder urine without bladder-wall involvement has occurred. This is seen primarily in diabetics with high urine glucose levels.48-50 Occasionally bladder vesicles have been found without bacteria in the bladder wall corresponding to Class III of Redewill.21
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