Emphysematous Cystitis

In Brief Objectives: Emphysematous cystitis is a rare, gas-forming infection of the urinary tract that classically occurs in older diabetic women. We described a combination of pregnancy and cesarean delivery, which predisposed our patient to glycosuria and inoculated coliform bacteria into the bladder causing emphysematous cystitis. Case: A 32-year-old African multigravida presented 17 days following an uncomplicated primary low transverse cesarean section with suprapubic crepitance. A computed tomography scan showed an enlarged bladder measuring 13.1 × 14.1 cm. The patient was diagnosed with emphysematous cystitis, then managed with intravenous antibiotics and transurethral drainage of air, purulent material, blood clots, and 1 L of urine. Discussion: Although there was no formal documentation of glycosuria in her medical records, we believe it is very likely this played a role in the pathogenesis of her emphysematous cystitis. It is possible that our patient experienced glycosuria by way of physiologic glycosuria of pregnancy, an undiagnosed serum glucose intolerance, or related to administration of dextrose-containing IV fluids during the cesarean. Conclusion: Emphysematous cystitis is a unique postcesarean complication, which may present in atypical populations postpartum. A case of a 32-year-old African multigravida presented 17 days following an uncomplicated primary low transverse cesarean section with suprapubic crepitance.