Emphysematous cystitis in patient with acute myeloid leukemia

Abstract

Introduction: Emphysematous cystitis is a rare infection of the lower urinary tract characterized by the presence of gas in the bladder wall and lumen, more common in middle-aged women, especially those with diabetes mellitus, and often associated with Escherichia coli. On the other hand, acute myeloid leukemia is an aggressive cancer of the white blood cells that presents with symptoms such as anemia and increased bleeding tendency. Diagnosis is based on the presence of more than 20% blasts in the bone marrow, confirmed by immunohistochemistry and cytogenetic testing to guide appropriate treatment.

Purpose: This case presents the clinical features and management of emphysematous cystitis in a non-diabetic immunosuppressed setting.

Case presentation: An 80-year-old woman with a history of cholecystectomy and uterine cancer presents with severe abdominal pain, weight loss, severe anemia, and pancytopenia, suggestive of severe bone marrow dysfunction affecting blood cell production. She presented cachexia syndrome and abdominal pain. Emphysematous cystitis was diagnosed with a positive urine culture for Escherichia coli ESBL + and Enterococcus faecalis. Additionally, suggestive bone marrow dysplasia of myelodysplastic syndrome/acute myeloid leukemia was noted. Treatment included transfusions, antibiotics, and management of hematologic and urologic conditions.

Discussion and conclusion: Emphysematous cystitis is a condition where gas accumulates in the bladder, typically caused by bacteria such as E. coli, primarily affecting older women with diabetes. It is diagnosed using X-rays and CT scans, treated with antibiotics, and sometimes requires surgery. Acute myeloid leukemia is a cancer of the bone marrow that results in abnormal myeloid cell production. It is diagnosed through bone marrow tests and treated with chemotherapy. It can lead to serious complications such as tumor lysis syndrome and cytopenias. Emphysematous cystitis is a rare and severe infection of the lower urinary tract, characterized by gas in the bladder. This case highlights the importance of comprehensive evaluation and coordinated management in patients with multiple medical conditions. Further research is needed to optimize the treatment of both emphysematous cystitis and AML.