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 55-year-old woman with ADPKD and PLD (Fig. ) and a history of a hepatic cyst infection (6 months and 1 year prior to the current event) developed fever (38.9 °C) and right upper-quadrant abdominal pain during a stay abroad. Lanreotide treatment (120 mg) was started 2 months earlier. She was hospitalized in a foreign country. At admission, serum CRP and liver enzymes were not determined, but serum white blood cell count was 9.0 × 10e9/L. Liver enzymes on day 4 after admission were not raised (AST 17 U/L, ALT 19 U/L, ALP 52 U/L, and GGT 39 U/L). A chest radiograph and abdominal ultrasound (performed on the day of admission and 1 day after, respectively) were unremarkable. A chest radiograph was repeated on the second day of admission and showed right-sided abnormalities compatible with either atelectasis or pneumonia. In contrast, 18F-FDG PET/CT (performed 3 days after admission) was unremarkable. All blood cultures were negative. Under the suspicion of hepatic cyst infection, the patient was hospitalized for 4 days and treated by local physicians with intravenous ampicillin-tazobactam, vancomycin, and meropenem. This was followed by oral amoxicillin/clavulanic acid for a total of 90 days. Recovery was uneventful.