Multiple liver cyst infection caused by Salmonella ajiobo in autosomal dominant polycystic kidney disease.
Most Salmonella infections are usually self-limited; however, some cases of enteritis result in bacteremia, and there have been reports of extra-intestinal manifestations. Cyst infections are rare, and few cases have been reported. We report a 77-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) complicated with a multiple liver cyst infection caused by Salmonella ajiobo. The patient was hospitalized for fever, abdominal pain, and diarrhea. The blood culture identified Salmonella sp., but the source of infection was not detected by computed tomography or echography. The patient was initially treated with meropenem followed by fluoroquinolones for 3 weeks; however, her C-reactive protein level was high (10-20 mg/dL) even after the antimicrobial therapy. The patient had a fever again on day 51, and Salmonella sp. was detected again from 2 sets of blood cultures. Despite the antimicrobial treatment, her general condition gradually deteriorated, and she died on day 66. The autopsy revealed that most of the liver had been replaced by cysts. Several cysts filled with pus were detected and Salmonella ajiobo was identified in the pus of the infected cysts.
Department of Nephrology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan.
Akihiro
A
Himeno
Hiromichi
H
Suzuki
Yumiko
Y
Suzuki
Hiroshi
H
Kawaguchi
Taisuke
T
Isozaki
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use; D003560:Cysts / Q000382:microbiology*; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D008107:Liver Diseases / Q000382:microbiology*; D000077731:Meropenem; D000077266:Moxifloxacin; D016891:Polycystic Kidney, Autosomal Dominant / Q000382:microbiology*; D011804:Quinolines / Q000627:therapeutic use; D012475:Salmonella / Q000302:isolation & purification; D012480:Salmonella Infections / Q000150:complications* / Q000188:drug therapy; D013845:Thienamycins / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D013845:Thienamycins; D000077731:Meropenem; D000077266:Moxifloxacin