A 54-year-old woman with ADPKD and PLD (Fig. ) presented with fever (39.6 °C) and cold shivers without abdominal pain, after having experienced abdominal complaints during a few weeks following each lanreotide injection. Lanreotide treatment (120 mg) was started 5 months earlier. At admission, serum CRP was 245 mg/L and some liver enzymes were elevated (ALT 62 U/L, ALP 119 U/L, and GGT 83 U/L). Leukocyturia was excluded with urine sediment analysis. Abdominal ultrasound showed no abnormalities, except for gallbladder sludge. Blood cultures grew E. coli. The patient was hospitalized for 3 days and treated by local physicians under the suspicion of hepatic cyst infection with cefuroxime intravenously. At discharge, treatment was switched to ciprofloxacin for another 11 days. Recovery was uneventful.
A 56-year-old woman with ADPKD and PLD (Fig. ) and a history of hepatic cyst infection developed right lower-quadrant abdominal pain and experienced a loss of appetite. The patient had no fever. Lanreotide injections (120 mg) were started 3 months earlier. At admission, laboratory investigations revealed increased serum CRP (156 mg/L) and increased serum ALP and GGT (123 U/L and 106 U/L, respectively). Urine sediment analysis revealed leukocyturia. Under the diagnosis of hepatic cyst infection, the patient was treated with cefuroxim/metronidazole intravenously for 1 day. Blood and urine cultures remained negative. 18F-FDG PET/CT (performed 4 days after admission) showed signs of a hepatic cyst infection (Supplementary Fig. 1B). Treatment was switched to oral ciprofloxacin for another 80 days. After 3 days, the patient was discharged. Recovery was uneventful.