{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:59Z","timestamp":1756339439247,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,31]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>A 15-year-old female adolescent with a medical history of recurrent urinary tract infections and grade 1 left-sided vesicoureteral reflux presented to the emergency room with abdominal and back pain. Labs revealed a haemoglobin A1c (HbA1c) of 9.1% and a random blood glucose of 200\u2009mg\/dL, consistent with new-onset diabetes mellitus. Nasopharyngeal COVID-19 PCR test returned positive. A CT scan of the abdomen and pelvis revealed bilateral attenuation of the kidneys and air in the bladder, which was confirmed by pelvic ultrasound. Gas subsequently resolved 2\u2009days later after treatment with antibiotics, and a diagnosis of emphysematous cystitis was made. Emphysematous cystitis in the paediatric population is an extremely rare condition with four cases reported in the literature. Furthermore, there has been a reported association between COVID-19, cystitis and non-typical course of urinary symptoms. Local inflammation obstructing transportation of formed gas is one of the proposed mechanisms underlying emphysematous cystitis, and so COVID-19 may be yet another predisposing factor.<\/jats:p>","DOI":"10.1136\/bcr-2021-245779","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T11:40:42Z","timestamp":1643888442000},"page":"e245779","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Emphysematous cystitis with bilateral pyelonephritis in a pediatric patient with COVID-19"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6148-6409","authenticated-orcid":false,"given":"Brent Liu","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Owen","family":"Brewer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA"},{"name":"Department of Emergency Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam R","family":"Cross","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,3]]},"reference":[{"key":"2025082703563937000_15.2.e245779.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.06930.x"},{"key":"2025082703563937000_15.2.e245779.2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3180307c3a"},{"key":"2025082703563937000_15.2.e245779.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)40151-0"},{"key":"2025082703563937000_15.2.e245779.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(96)00501-8"},{"key":"2025082703563937000_15.2.e245779.5","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s40249-020-00662-x","article-title":"Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues","volume":"9","author":"Li MY","year":"2020","journal-title":"Infect Dis Poverty"},{"key":"2025082703563937000_15.2.e245779.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.mehy.2020.110375","article-title":"COVID-19 inflammation results in urine cytokine elevation and causes COVID-19 associated cystitis (CAC)","volume":"145","author":"Lamb","year":"2020","journal-title":"Med Hypotheses"},{"key":"2025082703563937000_15.2.e245779.7","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.22.3.g02ma06543"},{"key":"2025082703563937000_15.2.e245779.8","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1056\/NEJMicm1509543","article-title":"Emphysematous cystitis","volume":"375","author":"Tzou","year":"2016","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025082703563937000_15.2.e245779.9","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1067\/j.cpradiol.2016.02.004","article-title":"Complicated genitourinary tract infections and mimics","volume":"46","author":"Yu","year":"2017","journal-title":"Curr Probl Diagn Radiol"},{"key":"2025082703563937000_15.2.e245779.10","unstructured":"In Amy C , Weintrob DJS Stephen B , Calderwood M , eds. 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