Abstract
Emphysematous cystitis (EC) is a rare gas-forming bladder infection that can also affect non-diabetic elderly patients. We report a 93-year-old woman with severe cardiac comorbidities who presented with abdominal pain, elevated inflammatory markers, and acute kidney injury. CT imaging revealed intraluminal and intramural gas with bilateral hydronephrosis. Urine cultures grew E. coli and E. faecalis, prompting targeted antibiotics and bladder drainage. Despite appropriate management, her condition worsened and she died from cardiac complications. This case highlights the need for early recognition, careful clinical assessment, and comorbidity-driven treatment strategies.