VIÊM BÀNG QUANG LIÊN QUAN ĐẾN SỬ DỤNG KETAMINE: BÁO CÁO CA BỆNH VÀ KHẢO CỨU Y VĂN

Abstract

Background: Ketamine-induced cystitis is an increasingly recognized urological complication among individuals with chronic recreational ketamine abuse. Because its clinical manifestations often overlap with those of recurrent urinary tract infection, interstitial cystitis, or other inflammatory bladder disorders, delayed or incorrect diagnosis is common. Case presentation: We report the case of a 33-year-old man with an 8-year history of intranasal ketamine abuse who presented with severe lower urinary tract symptoms, including urinary frequency, urgency, dysuria, gross hematuria, and suprapubic pain. He had previously received multiple courses of treatment for presumed urinary tract infection without clinical improvement. Urinalysis revealed mild leukocyturia, whereas urine culture was negative. Computed tomography of the urinary tract demonstrated a contracted bladder with diffuse irregular bladder wall thickening without evidence of stones or mass lesions. Cystoscopy showed markedly reduced bladder capacity and diffusely hyperemic, inflamed bladder mucosa with bleeding tendency. Histopathologic examination of bladder biopsy specimens revealed chronic cystitis without evidence of malignancy. Based on the history of prolonged ketamine exposure, characteristic clinical presentation, imaging findings, cystoscopic appearance, and histopathologic results, a diagnosis of ketamine-induced cystitis was established. The patient was treated with strict cessation of ketamine use and symptomatic medical therapy, resulting in marked clinical improvement after 7 days. Conclusion: Ketamine-induced cystitis should be considered in young patients presenting with persistent lower urinary tract symptoms, negative urine culture, and poor response to conventional antimicrobial therapy, particularly when there is a history of ketamine use. Careful history taking, combined with imaging, cystoscopy, and histopathologic evaluation, is critical for accurate diagnosis. Absolute cessation of ketamine remains the cornerstone of management and is essential for long-term clinical outcome.