II. Definitions

  1. Pneumaturia
    1. Gas passed with urination
  2. Emphysematous Cystitis
    1. Bladder wall infection with gas forming organisms (e.g. Proteus)
  3. Emphysematous Pyelonephritis
    1. Renal parenchymal infection with gas forming organisms (e.g. Proteus)

III. Causes

  1. Bladder instrumentation (cystoscopy)
  2. Fistula from bowel or vagina
    1. Complication from Crohn's Disease, Diverticulitis, cancer, Trauma
  3. Renal tumor infarction
  4. Urinary diversion
  5. Scuba Diving with p-valve (diverts urine outside suit)
  6. Urinary Tract Infection with gas forming organisms that ferment lactate (high risk, see precautions below)
    1. Results in Emphysematous Cystitis or Emphysematous Pyelonephritis
    2. Most common in poorly controlled Diabetes Mellitus
    3. Organisms (may cause staghorn calculi, high Urine pH)
      1. Proteus species
      2. Escherichia coli
      3. KlebsiellaPneumonia
      4. Candida
      5. Clostridium

IV. Precautions

  1. Acute infection with Emphysematous Cystitis or Emphysematous Pyelonephritis
    1. Pneumaturia due to gas forming organism infection requires early diagnosis and broad spectrum antibiotics
    2. Delayed diagnosis is associated with high mortality (20%)
    3. Emphysematous Pyelonephritis

V. References

  1. Swadron and Schoenberger in Herbert (2018) EM:Rap 18(6):1
  2. Youssef (2013) Case Reports in Medicine
    1. https://www.hindawi.com/journals/crim/2013/730549/

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Ontology: Emphysematous cystitis (C0221230)

Concepts Disease or Syndrome (T047)
SnomedCT 52123000
Italian Cistite enfisematosa
Japanese 気腫性膀胱炎, キシュセイボウコウエン
English emphysematous cystitis (diagnosis), emphysematous cystitis, Cystitis pneumatoides, Emphysematous cystitis, Emphysematous cystitis (disorder), Cystitis, emphysematous
Czech Emfyzematózní cystitida
Hungarian emphysematosus cystitis
Spanish cistitis enfisematosa (trastorno), cistitis enfisematosa, cistitis neumatoidea, Cistitis enfisematosa
Portuguese Cistite enfisematosa
Dutch emfysemateuze cystitis
French Cystite emphysémateuse
German Cystitis emphysematosa

Ontology: Pneumatouria (C0232894)

Concepts Sign or Symptom (T184)
SnomedCT 20154006
Italian Pneumaturia
Japanese 気尿症, キニョウショウ
English pneumaturia, bubbles in urine (symptom), bubbles in urine, Pneumatouria, pneumouria, Pneumaturia, Pneumouria, Pneumatouria (finding)
Czech Pneumaturie
Hungarian pneumaturia
Spanish neumaturia (hallazgo), neumaturia, Neumaturia
Portuguese Pneumatúria
Dutch pneumaturie
French Pneumaturie
German Pneumaturie

Ontology: Emphysematous pyelonephritis (C0403379)

Concepts Disease or Syndrome (T047)
SnomedCT 236373001
Spanish Pielonefritis enfisematosa, pielonefritis enfisematosa (trastorno), pielonefritis enfisematosa
Portuguese Pielonefrite enfisematosa
Dutch emfysemateuze pyelonefritis
Italian Pielonefrite enfisematosa
French Pyélonéphrite emphysémateuse
German emphysematoese Pyelonephritis
Czech Emphysematous pyelonephritis
Japanese キシュセイジンウジンエン, 気腫性腎盂腎炎
English emphysematous pyelonephritis, pyelonephritis emphysematous, pyelonephritis emphysematous (diagnosis), Emphysematous pyelonephritis, Emphysematous pyelonephritis (disorder)
Hungarian Emphysematosus pyelonephritis