J Korean Med Sci.  2013 Jun;28(6):955-958. 10.3346/jkms.2013.28.6.955.

Successfully Treated Escherichia coli-Induced Emphysematous Cyst Infection with Combination of Intravenous Antibiotics and Intracystic Antibiotics Irrigation in a Patient with Autosomal Dominant Polycystic Kidney Disease

• Kim H
• Cho Park H
• Lee S
• Lee J
• Cho C
• Kim DK
• Hwang YH
• Oh KH
• Ahn C

• KMID: 2158048
• DOI: http://doi.org/10.3346/jkms.2013.28.6.955

Abstract

A 62-yr-old woman with an autosomal dominant polycystic kidney disease (ADPKD) was admitted to our hospital for further evaluation of intermittent fever, nausea and left flank discomfort. The computed tomography (CT) scan revealed a gas-forming, infectious cyst of approximately 8.1 cm in size in left kidney lower pole. Escherichia coli was identified from the cyst fluid culture examination. Her symptoms improved only after the concomitant use of intravenous ciprofloxacin and an intracystic irrigation of ciprofloxacin through a percutaneous cystostomy drainage. Our case presents the successfully treated emphysematous cyst infection with combination of intravenous antibiotics and intracystic antibiotic therapy instead of surgical management.

Keyword

Autosomal Dominant Polycystic Kidney Disease; Escherichia coli; Emphysematous

MeSH Terms

Anti-Bacterial Agents/*therapeutic use
Ciprofloxacin/*therapeutic use
Cystostomy
Cysts/microbiology
Escherichia coli Infections/complications/*drug therapy
Female
Humans
Injections, Intravenous
Middle Aged
Polycystic Kidney, Autosomal Dominant/complications/*diagnosis
Therapeutic Irrigation
Tomography, X-Ray Computed
Anti-Bacterial Agents
Ciprofloxacin

Figure

• 

  Fig. 1 Comparison of intravenous contrast-enhanced CT scans between at diagnosis and on day 6 following the treatment. (A) A 8.1-cm sized complicated cyst is displayed in left kidney lower pole with air-mottled soft tissue density. (B) The cyst decreased of its size to 4.7 cm with internal mottled air attenuation after 6-days antibiotics irrigation through percutaneous cystostomy drainage.

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