{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T10:15:46Z","timestamp":1781345746565,"version":"3.54.1"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Emphysematous cystitis (EC) is a rare anaerobic bacterial infection, often linked to diabetes, neurogenic bladder, or radiotherapy. Severe cases can weaken the bladder wall, causing spontaneous rupture, which may be intra- or extraperitoneal. While conservative treatment with drainage and antibiotics is possible, intraperitoneal rupture requires surgery to prevent septic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>A 61-year-old dialysis-dependent patient with a history of lumbotomy for renal calculus and type 2 diabetes was admitted for confusional syndrome and shock. Workup showed inflammatory syndrome, renal failure, and purulent urine. Imaging revealed EC with a retro vesical abscess and suspected bladder rupture. Surgical exploration confirmed spontaneous intraperitoneal bladder rupture with necrosis. Debridement, bladder suturing, cystostomy, and drainage were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>\n                      EC is a rare bladder infection characterized by gas accumulation, primarily associated with diabetes. It is caused by facultative anaerobes such as\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      . EC can range from asymptomatic to severe, potentially leading to spontaneous intra- or extraperitoneal bladder rupture, a rare but life-threatening complication. CT scans are the gold standard for diagnosis. Treatment of uncomplicated EC includes broad-spectrum antibiotics, bladder drainage, and glycemic control. Severe cases, especially intraperitoneal rupture, may require surgical intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>EC is a rare but severe bladder infection with a misleading presentation, which can delay diagnosis. If left untreated, it may lead to life-threatening complications such as bladder rupture and septic shock, requiring immediate surgical intervention.<\/jats:p>\n                    <jats:p>Our goal is to identify key diagnostic features that facilitate the early detection and effective management of emphysematous cystitis, preventing severe complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111458","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T19:29:47Z","timestamp":1747942187000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Emphysematous cystitis: A hidden danger of bladder rupture and sepsis \u2013 Case report"],"prefix":"10.1097","volume":"132","author":[{"given":"Ayoub","family":"Mamad","sequence":"first","affiliation":[{"name":"Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilyass","family":"Zerda","sequence":"additional","affiliation":[{"name":"Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Amine","family":"Bibat","sequence":"additional","affiliation":[{"name":"Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siham","family":"El Msaadi","sequence":"additional","affiliation":[{"name":"Emergency Radiology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Messaoud","sequence":"additional","affiliation":[{"name":"Emergency Radiology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Elkhader","sequence":"additional","affiliation":[{"name":"Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"3","key":"R1-23-20260311","first-page":"735","article-title":"Bacterial urinary tract infections in diabetes","volume":"11","author":"Patterson","year":"1997","journal-title":"Infect. 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