Presentation
Bilateral loin pain, pneumaturia, and septicemia in a diabetic patient. Prior splenectomy.
Patient Data
Bilateral staghorn calculi, gas in both pelvicalyceal systems, ureters, and bladder. Intraparenchymal gas in the left kidney. No urinary catheter.
Gallbladder emphysema with pericholecystic gas and fluid.
Soft-tissue gas in the right hindquarter, sciatic notch, iliac blade, sacroiliac joint, iliopsoas muscle, extradural space, L4 and L5 vertebral bodies, L3 Hahn’s cleft, and the L3/4 and L4/5 discs.
Thin-walled fluid-filled cystic structure in the pelvis with no adjacent inflammatory features, possible abscess.
Prior splenectomy. Irregular liver contour compatible with cirrhosis. Minor ascites.
Case Discussion
Septicemia caused by gas-forming organisms with contiguous and hematogenous spread to uncommon and rare sites in a patient with impaired immunity due to advanced age, diabetes, staghorn calculi, and splenectomy.
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