A Case of Emphysematous Cystitis in an Elderly Male Diabetic Patient with Benign Prostatic Hyperplasia treated with an SGLT2-inhibitor

Abstract

Emphysematous cystitis is a rare and complicated urinary tract infection associated with gas formation in the bladder wall.  This is commonly associated with poorly controlled diabetes mellitus in elderly women. The case presented involves a male diagnosed with emphysematous cystitis while being treated with empagliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2i), for type-2 diabetes mellitus (T2DM).  He was noted to have a past medical history of symptomatic benign prostatic hyperplasia, for which he was prescribed tamsulosin.  Treatment was non-operative, and he fully recovered with no long-term sequelae.  SGLT2i medications have been beneficial in improving glycemic control for patients with T2DM, though the risk for severe urinary tract infections remains controversial.  After reviewing the literature, other cases of genitourinary infective complications have been reported.