Emphysematous Cystitis: A Case Report and Literature Review.

Urinary tract infections (UTIs) are one of the most common infectious diseases worldwide, predominantly affecting women due to anatomical factors. Among UTIs, emphysematous cystitis (EC) is a rare but clinically significant entity characterized by gas presence in the bladder wall or lumen, often caused by gram-negative bacteria like Escherichia coli and Klebsiella pneumoniae. Diagnosis is challenging due to nonspecific symptoms such as dysuria, abdominal pain, and occasionally pneumaturia, with computed tomography being the diagnostic method of choice. We report the case of a 65-year-old male with diabetes and a significant surgical history, who was admitted for abdominal pain and nausea due to an intestinal obstruction. Incidental findings on computed tomography revealed EC, necessitating antimicrobial therapy adjustment. The patient was successfully managed conservatively with meropenem, glycemic control, and surgical follow-up for associated hernia complications. This case emphasizes the importance of the early recognition and multidisciplinary management of EC, particularly in high-risk patients like diabetics. Timely imaging and targeted antibiotic therapy are crucial for reducing complications and improving outcomes in such complex clinical scenarios.