Solitary tubercular renal cyst in a postpartum lady masquerading as an infected giant renal cyst with urosepsis.

Renal tuberculosis presenting as renal cyst is rare. Diagnosing renal tuberculosis in pregnancy is usually delayed due to its atypical presentation. We present a 28-year-old postpartum lady who delivered a healthy baby one month back, with history of intermittent fever and chills. She had high spiking fever (102° F), tachycardia (130/min) and computed tomography showed a 16 × 10 cm right renal cyst. Percutaneous drainage was done, 2 litres of thick pus drained and culture was sterile. After three weeks, deroofing and marsupialization of cyst was done. Biopsy revealed granulomatous inflammation composed of epitheliod histiocytes with central incipient necrosis suggestive of tuberculosis. She was treated with anti-tubercular drugs. As the infant was healthy and had no evidence of tuberculosis, no treatment was initiated. The mother is on follow up for 2 years. This case highlights the rare presentation of renal tuberculosis in puerperium.

Infected simple renal cyst. Case report.

OBJECTIVE: To present a new case of an infected simple renal cyst, its diagnosis and the treatment carried out. METHODS: 30 year-old female patient admitted to the Internal Medicine ward suffering a prolonged fever syndrome. On physical examination she presented tachycardia and pain in the left hypochondrium on deep palpation. Abdominal ultrasound revealed the existence of a great size left renal cyst with a highly echogenic content; this liquid hyperdensity was confirmed by simple and i.v. contrast CT scan. RESULTS: Cyst punction was performed through a lumbar via, getting approximately 400 millilitres of a clear and odourless yellow liquid; then it was sclerosed with ethanol. The microbiological study of the extracted liquid was negative. The patient's clinical evolution has been satisfactory and renal ultrasound controls were normal. CONCLUSIONS: Faced with a simple infected renal cyst whose location allows percutaneous lumbar approach, punction with synchronic sclerosis plus parenteral antibiotic therapy with ciprofloxacin is the recommended treatment.

The renal cyst infection caused by Salmonella enteritidis in a patient with autosomal dominant polycystic kidney disease: how did this pathogen come into the renal cysts?

A 40-year-old Japanese man was admitted to our hospital for investigation of fever and right flank pain starting after watery diarrhea. Salmonella enteritidis was cultured from samples of stool and blood. Although his diarrhea subsided soon, high fever persisted and flank pain got worse. Magnetic resonance imaging (MRI) revealed four areas of abnormal intensity in renal cysts and computed tomography showed the same findings. Renal cysts infection was diagnosed. After ultrasound-guided aspiration of these cysts, his fever subsided. Culture of each aspirate grew Salmonella enteritidis. Although the route of cyst infection in ADPKD generally remains unclear, the clinical course of our patient may indicate that gastrointestinal tract infection progressed to renal cyst infection when bacteremia occurred due to bacterial translocation.

[Clinic laboratory and integrated ultrasonic study in patients with liquid formation in diphtheria catamnesis].

It has been determined that in 9.3% of patients suffered from diphtheria of fauces in catamnesis till 10 years cysts of renal sinus were revealed by ultrasonic study which should be differentiated with calicopieloectasies. The method of pharmocoechography with introducing diuretics is very informative and reliable way of differential diagnostics. The cysts of renal sinus have been recorded in the indices of the study by ultrasonic study. It has been found that in patients suffered from severe diphtheria are in 1.8-2 times higher in frequency than in patients with slight and intermediate degree of disease. In 57.1% of patients with cysts of renal sinus chronic TIN was diagnosed. Frequency of cysts of renal sinus in patients with diphtheria exceeds frequency by older people in 3-9 times. Patients with renal cysts suffered from diphtheria should be under urological control in long-term regular medical check-up and need ultrasonic study with pharmocoechography and echodoplerography of renal vessels.

[Renal cyst infected by Brucella]. / Quiste renal infectado por Brucela.

OBJECTIVES: To report one case of renal cyst infected by Brucella, an exceptional pathology in our environment. METHODS: 82-year-old patient who was referred from his primary care physician for persistent microhematuria and piuria without evidence of infection. RESULTS: Radiological studies (XR+US+CTscan) showed a left renal cyst with parietal calcifications. Pathologic study was compatible with complicated cyst, with cultured (+) to Brucella spp. CONCLUSIONS: Renal involvement by Brucella is exceptional, and the cystic renal involvement is by far one of the more exceptional manifestations.

Candida krusei renal cyst infection and measurement of amphotericin B levels in cystic fluid in a patient receiving AmBisome.

Candida krusei is an opportunistic pathogen commonly implicated in urinary tract infections in immunocompromised patients. We present the first case of C. krusei renal cyst infection, occurring in a post-liver and kidney transplant patient with autosomal dominant polycystic kidney disease. Her persistent candiduria and fevers were refractory to prolonged therapy with AmBisome (Fujisawa Pharmaceuticals Co. Ltd., Osaka, Japan). She eventually required bilateral nephrectomies of her native kidneys. Cystic fluid was aspirated from six hemorrhagic and six nonhemorrhagic cysts. Cystic fluid cultures yielded C. krusei. Fluid from the nonhemorrhagic cysts was also analyzed for amphotericin B levels, measured using a bioassay. Free amphotericin B levels in the cysts were lower than the minimal inhibitory concentration for amphotericin B for this organism. We provide the first description of amphotericin B levels in cystic fluid obtained during bilateral nephrectomies.

Residual contrast medium in the cortex of the kidney around an infected renal cyst on CT: case report.

We present a case of a patient with an infected renal cyst. Delayed computed tomography showed residual contrast medium in the cortex of the kidney around it. Delayed computed tomography might be useful to identify an infected renal cyst.

[Solitary infected renal cyst: a case report].

A 48-year-old man was admitted to our hospital because of high fever and left flank pain. Laboratory findings revealed a high white blood cell count, high C-reactive protein level, and severe pyuria. Sonographic examination revealed an enlargement of the cyst at the upper pole of the left kidney that had already been detected. Percutaneous drainage was performed for the cyst and 60 ml of purulent fluid was obtained. Bacterial culture of the fluid was positive for Propionibacterium acnes and gamma-Streptococcus. The drainage and administration of povidone-iodine was continued for 7 days. The size of the cyst was reduced with disappearance of symptoms.

Infected renal cyst simulating acute abdomen. Case report.

Renal cysts are rarely infected. The diagnosis should not represent a problem with the current techniques: however the condition can simulate acute abdomen in which case resection of the cyst roof and drainage is recommended.

Endotoxin provocation of experimental renal cystic disease.

Germ free rats provide a unique model in which to assess biological response to environment. In 48 germ-free male, Sprague-Dawley rats we examined the consequences of oral exposure to nordihydroguaiaretic acid (NDGA), a nephrotoxin; to Staphylococcus epidermidis and bacillus species, non-endotoxin-containing bacteria; to Escherichia coli and Proteus mirabilis, endotoxin-containing bacteria; and injected E. coli endotoxin on peripheral leukocyte counts and renal morphology. Morphological changes were evaluated by light microscopy and scored blindly on a 0 to 4+ scale for 15 parameters of renal structure. Means of these renal "pathology scores" correlated with counts of polymorphonuclear leukocytes and lymphocytes in the peripheral blood. The highest counts and scores were found in rats given NDGA and exposed to endotoxin, either by injection or by oral feeding of endotoxin-containing bacteria. Counts and scores were lower in the absence of endotoxin and with non-endotoxin-containing bacteria, given alone or in combination with either NDGA or endotoxin. Results exclude bacterial colonization and intrarenal accumulation of NDGA as causes of nephropathy. They indicate that endotoxin and NDGA act synergistically to provoke renal damage in the germ free NDGA-fed rat and suggest that leukocytes are involved in the process.