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 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.