Endocrine Abstracts

Introduction: Emphysematous cystitis is a rare rare condition encountered mainly in poorly balanced diabetic patients. It represents a rare cause of septic shock and is characterized by the presence of air in the wall and/or the bladder lumen. Abdominopelvic computed tomography remains the key examination to confirm the diagnosis.

Observation: We report the case of a 65-year-old patient with a history of non-ill-controlled type 2 diabetes on sulfonylureas and complicated by diabetic retinopathy and diabetic neuropathy. He was admitted for management of a glycemic imbalance associated with urinary burning and vomiting. Clinical examination found pelvic tenderness. The balance shows neutrophilic polymorphonuclear leukocytosis with white blood cells at 11550/ul and a CRP at 24.8 mg/l. He has unbalanced diabetes (HBA1C=9%) and functional renal failure (creatinine =76.13 mg/l). Thoraco-abdomino-pelvic CT demonstrates emphysematous cystitis. The evolution is favorable under antibiotic therapy, insulin therapy and bladder drainage.

Conclusion: Urinary tract infections are more frequent and more serious in diabetic patients. They can have a severe prognosis, hence the need for early diagnosis and rapid treatment.