Document Detail


Hepatic cyst infection in autosomal dominant polycystic kidney disease.
MedLine Citation:
PMID:  2198396     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To characterize the syndrome of hepatic cyst infection in autosomal dominant polycystic kidney disease (ADPKD) and to review its diagnosis and management, we retrospectively studied five such cases in patients from our institution and nine detailed case reports from the literature. The clinical manifestations were an acute (58%) or subacute (42%) febrile illness, typically associated with tenderness in the right upper quadrant, leukocytosis, a very high erythrocyte sedimentation rate, but minor abnormalities of liver function tests. Bacteremia was present in 7 of 11 patients. Enterobacteriaceae grew in pure culture from the cyst fluid in 9 of 12 patients. Complex cysts were observed by ultrasonography (in four of eight patients), computed tomography (in six of nine), and magnetic resonance imaging (in two of two). 111In leukocyte scans were positive in all four patients in whom they were done, and 67Ga scans were positive in only one of three patients. An unfavorable outcome was observed in six of seven patients treated with only antibiotics, in contrast with one of seven patients who received antibiotics and early drainage. In two patients, ciprofloxacin cyst levels were 2.3 and 4.8 times higher than the level in serum; in a third patient, cyst levels remained in therapeutic range 30 hours after the last dose of ciprofloxacin, at which time serum levels were undetectable. Clinical and laboratory features and the use of modern scanning techniques facilitate a prompt diagnosis of infection in hepatic cysts in ADPKD. The treatment of choice is a combination of percutaneous drainage and antimicrobial therapy.
Authors:
A Telenti; V E Torres; J B Gross; R E Van Scoy; M L Brown; R R Hattery
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  65     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-09-06     Completed Date:  1990-09-06     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  933-42     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Ciprofloxacin / analysis,  therapeutic use
Cysts / diagnosis,  drug therapy,  pathology*
Enterobacter
Enterobacteriaceae Infections / drug therapy,  pathology*
Escherichia coli Infections / pathology
Female
Genes, Dominant
Humans
Klebsiella Infections / pathology
Liver Diseases / diagnosis,  drug therapy,  pathology*
Male
Middle Aged
Polycystic Kidney Diseases / genetics*
Retrospective Studies
Chemical
Reg. No./Substance:
5E8K9I0O4U/Ciprofloxacin
Comments/Corrections
Comment In:
Mayo Clin Proc. 1990 Jul;65(7):1020-5   [PMID:  2198393 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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