DOI: 10.36347/sjmcr.2016.v04i10.019

Pages: 765-767

A 70-year-old female patient underwent an infusion of clomipramine and was admitted to the psychiatry department of our hospital because she could not eat. She had a history of depression and diabetes mellitus. On the evening of that day, she had a fever. The following day, she underwent whole body computed tomography to detect the focus of inflammation, which depicted diffuse air bubbles within the bladder wall, suggesting potentially life-threatening, emphysematous cystitis (EC). An infusion of piperacillin-tazobactam was initiated and an indwelling catheter was inserted into the bladder. On the third day of hospitalization, her blood pressure, respiratory condition and consciousness deteriorated, and she was transferred to the intensive care unit. She was diagnosed with septic shock with multiple organ failure including takotsubo cardiomyopathy, induced by emphysematous cystitis and continuous treatment with antibiotics along with mechanical ventilation and noradrenalin support were provided. Her multiple organ failure gradually improved even she became temporally cardiac arrest. After she became able to eat for herself and walk with assistance, she was transferred to another hospital for rehabilitation. The patient was an elderly woman with diabetes mellitus, thus these factors might have affected the occurrence of EC. It is also possible that it was a side effect of the administration of tricyclic or tetracyclic antidepressants, because these antidepressants have side effects such as urinary hesitancy, dysuria and urinary retention.