A 51-year-old woman with ADPKD and PLD (Fig. ) presented at the hospital because of right upper-quadrant abdominal pain, fever (38 °C), nausea, and vomiting. Lanreotide treatment (120 mg) was started 5 months earlier. At admission, serum CRP was 329 mg/L and serum liver enzymes were normal (AST 29 U/L, ALT 27 U/L, ALP 57 U/L, and GGT 39 U/L). Local physicians initiated piperacillin/tazobactam intravenously under the suspicion of hepatic cyst infection. Blood cultures grew E. coli. Abdominal CT at admission showed no sign of hepatic cyst infection. Patient was hospitalized for 3 days. Treatment was switched to ciprofloxacin twice daily at discharge and continued for 2 weeks. 18F-FDG PET/CT was performed 3 days after discharge and revealed two hepatic cysts showing signs of infection. Recovery was uneventful.
A 49-year-old woman with ADPKD and PLD (Fig. ) was referred to the hospital because of upper abdominal pain, fever (38.3 °C) with cold shivers and diarrhea. Lanreotide injections (120 mg) were started 2 months earlier. Because of complaints of bradycardia and hypotension, the lanreotide dose was adjusted to 90 mg after the first injection. At admission, serum CRP was 105 mg/L, with elevated ALP (150 U/L) and GGT (230 U/L). Urine sediment analysis revealed leukocyturia. During admission, a chest radiograph and abdominal ultrasound did not show abnormalities, whereas a magnetic resonance imaging scan showed an image of renal cyst hemorrhage in both kidneys. Under the suspicion of hepatic cyst infection, the patient was treated with oral ciprofloxacin. Urine and blood cultures remained negative. Hospitalisation lasted 5 days, and in total ciprofloxacin was given during 42 days. Recovery was uneventful.