Titre
Hepatic cyst infection in autosomal dominant polycystic kidney disease
Type
synthèse (review)
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Telenti, A.
Auteure/Auteur
Torres, V. E.
Auteure/Auteur
Gross, J. B., Jr.,
Auteure/Auteur
Van Scoy, R. E.
Auteure/Auteur
Brown, M. L.
Auteure/Auteur
Hattery, R. R.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0025-6196
Statut éditorial
Publié
Date de publication
1990-07
Volume
65
Numéro
7
Première page
933
Dernière page/numéro d’article
42
Notes
Journal Article
Review --- Old month value: Jul
Review --- Old month value: Jul
Résumé
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.
Sujets
PID Serval
serval:BIB_AC0473390594
PMID
Date de création
2008-01-25T13:45:29.803Z
Date de création dans IRIS
2025-05-21T03:00:43Z