Author Presentation and comorbidities Organism Imaging and investigations Treatment Outcome Adeyemi and Flaherty [4 ] 76 yo M with foul-smelling urine/T2DM Escherichia coli and Klebsiella pneumoniae .Urine culture positive, blood culture negative, CT scan-bladder wall thickening with air in the bladder wall. IV piperacillin/tazobactam followed by ertapenem Discharged after 14 days Liao et al. [5 ] 65 yo F with dysuria and abdominal pain/HTN, T2DM Klebsiella pneumoniae Leukocytosis, hyperglycemia, lactic acidemia, acute kidney injury, urine cultures positive, and blood cultures negative. CT-bladder wall contoured by mottled air bubbles. Bladder drainage and IV antibiotics Discharged after 10 days Zhang et al. [6 ] 66 yo M with confusion and jaundice/HTN, T2DM, PUD Klebsiella pneumoniae Leukocytosis, transaminitis, acute kidney injury, and pelvic CT-intramural gas formation in the bladder. Complicated by septic shock and was being treated with meropenem Died after massive resuscitation efforts Suzuki et al. [7 ] 75 yo M/dementia Klebsiella pneumoniae Urine and blood cultures positive, leukocytosis, acute kidney injury, pyuria, CT-emphysematous prostatic abscess, emphysematous cystitis, and renal abscess. Meropenem IV Discharged Nolazco et al. [8 ] 39 yo F/T2DM Klebsiella pneumoniae CT-gas in the bladder wall. Vancomycin, meropenem, and colistin, bladder drainage, strict glycemic control Discharged Wang et al. [9 ] 62 yo M with right leg pain/T1DM, recurrent UTI Klebsiella pneumoniae CT-extensive subcutaneous air involving the entire right lower limb and tracking up into the pelvis, as well as air within the wall of the bladder and the prostate. Surgical intervention for fasciitis and repeat CT scan still showed air bubbles in the pelvis, was given IV piperacillin-tazobactam and underwent cystoprostatectomy with ileal conduit Discharged after 13 days Ahmed et al. [10 ] 95 yo M with altered mental status/T2DM Klebsiella pneumoniae , Streptococcus pyogenesCT-hydronephrosis, a thick-walled urinary bladder with diverticula and air in the bladder wall suggestive of emphysematous cystitis. IV ceftriaxone and gentamicin Discharged after 4 weeks Bos et al. [11 ] 84 yo F with lower abdominal pain/T2DM Klebsiella pneumoniae and Enterococcus speciesCT-distended bladder measuring IV ceftriaxone Discharged after 10 days Wadekar et al. [12 ] 82 yo F with abdominal pain and vomiting/RA Escherichia coli CT-thickened urinary bladder with intramural air density. Nitrofurantoin and amikacin Discharged after 7 days Our case report 77 yo F with abdominal pain and nausea/HTN, T2DM Klebsiella pneumoniae CT-multiple air densities and extensive emphysematous cystitis. Vancomycin, meropenem, and metronidazole Transferred to in-patient hospice
