Management includes urgent surgical consultation for aggressive d bridement and administration of parenteral amphotericin B. Emphysematous cholecystitis is a severe form of acute cholecystitis characterized by gas production in and around the gallbladder wall. In contrast to acute cholecystitis, emphysematous cholecystitis occurs more commonly in males and is frequently associated with gangrene, perforation, and death. Symptoms, including fever and right upper quadrant pain, are initially similar to those of uncomplicated cholecystitis. Diagnosis involves the demonstration of gas within the lumen or walls of the gall bladder by ultrasound or CT scan. Prompt surgical intervention is necessary in addition to administering broad-spectrum antibiotics.
Emphysematous pyelonephritis is a severe form of renal infection with gas-forming organisms.
Escherichia coli is usually found, although other gram-negative bacilli and Candida spp. have been implicated. Symptoms of fever and flank pain are similar to classic pyelonephritis. Blood and urine cultures usually identify the causative pathogen. Demonstration of gas in the renal parenchyma on plain X-ray films or a CT scan is diagnostic. Antibiotics are directed broadly against potential uropathogens until culture results are known.