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Successful Treatment of Cyst Infection in an Infant With Autosomal Dominant Polycystic Kidney Disease Using Trimethoprim/Sulfamethoxazole.
Front Pediatr. 2020; 8:216.FP

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disease causing renal cysts. Reports on kidney cyst infection in children are rare despite cyst infections being important complications of ADPKD. Here, we report a case of a child without any medical history who had a urinary tract infection with sepsis at 7 months. Leukocyturia persisted despite antibiotic therapy because the infection was treatment-resistant. Initial ultrasound and contrast computed tomography were inconclusive because cysts could not be detected clearly, and a family history of renal cysts was not determined. Subsequently, history of paternal renal cysts, thick walls in infectious cystic lesions on diffusion-weighted magnetic resonance imaging (MRI), and multiple small lesions with high signals on T2-weighted imaging in both kidneys became apparent. Upon diagnosis of ADPKD with cyst infection, antibiotic therapy was switched from cefotaxime to trimethoprim/sulfamethoxazole to achieve better cyst penetration, which successfully resolved the infection. In this patient, MRI was effective for clear visualization and diagnosis of infectious lesions and small cysts in undiagnosed ADPKD with cyst infection. Administering antibiotics with better cyst penetration is important. Trimethoprim/sulfamethoxazole is an option for use in children. This is the first case report that describes ADPKD with cyst infection in an infant in detail.

Authors+Show Affiliations

Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan.Department of Pediatrics, Tottori Prefectural Central Hospital, Tottori, Japan.Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan.Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan.Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan.Asahigawaso Rehabilitation and Medical Center, Okayama, Japan.Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32582581

Citation

Yokoyama, Hiroki, et al. "Successful Treatment of Cyst Infection in an Infant With Autosomal Dominant Polycystic Kidney Disease Using Trimethoprim/Sulfamethoxazole." Frontiers in Pediatrics, vol. 8, 2020, p. 216.
Yokoyama H, Sakaguchi M, Yamada Y, et al. Successful Treatment of Cyst Infection in an Infant With Autosomal Dominant Polycystic Kidney Disease Using Trimethoprim/Sulfamethoxazole. Front Pediatr. 2020;8:216.
Yokoyama, H., Sakaguchi, M., Yamada, Y., Kitamoto, K., Okada, S., Kanzaki, S., & Namba, N. (2020). Successful Treatment of Cyst Infection in an Infant With Autosomal Dominant Polycystic Kidney Disease Using Trimethoprim/Sulfamethoxazole. Frontiers in Pediatrics, 8, 216. https://doi.org/10.3389/fped.2020.00216
Yokoyama H, et al. Successful Treatment of Cyst Infection in an Infant With Autosomal Dominant Polycystic Kidney Disease Using Trimethoprim/Sulfamethoxazole. Front Pediatr. 2020;8:216. PubMed PMID: 32582581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful Treatment of Cyst Infection in an Infant With Autosomal Dominant Polycystic Kidney Disease Using Trimethoprim/Sulfamethoxazole. AU - Yokoyama,Hiroki, AU - Sakaguchi,Mayumi, AU - Yamada,Yuko, AU - Kitamoto,Koichi, AU - Okada,Shinichi, AU - Kanzaki,Susumu, AU - Namba,Noriyuki, Y1 - 2020/06/02/ PY - 2020/02/17/received PY - 2020/04/14/accepted PY - 2020/6/26/entrez PY - 2020/6/26/pubmed PY - 2020/6/26/medline KW - autosomal dominant polycystic kidney disease KW - cyst infection KW - infant KW - magnetic resonance imaging KW - trimethoprim/sulfamethoxazole SP - 216 EP - 216 JF - Frontiers in pediatrics JO - Front Pediatr VL - 8 N2 - Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disease causing renal cysts. Reports on kidney cyst infection in children are rare despite cyst infections being important complications of ADPKD. Here, we report a case of a child without any medical history who had a urinary tract infection with sepsis at 7 months. Leukocyturia persisted despite antibiotic therapy because the infection was treatment-resistant. Initial ultrasound and contrast computed tomography were inconclusive because cysts could not be detected clearly, and a family history of renal cysts was not determined. Subsequently, history of paternal renal cysts, thick walls in infectious cystic lesions on diffusion-weighted magnetic resonance imaging (MRI), and multiple small lesions with high signals on T2-weighted imaging in both kidneys became apparent. Upon diagnosis of ADPKD with cyst infection, antibiotic therapy was switched from cefotaxime to trimethoprim/sulfamethoxazole to achieve better cyst penetration, which successfully resolved the infection. In this patient, MRI was effective for clear visualization and diagnosis of infectious lesions and small cysts in undiagnosed ADPKD with cyst infection. Administering antibiotics with better cyst penetration is important. Trimethoprim/sulfamethoxazole is an option for use in children. This is the first case report that describes ADPKD with cyst infection in an infant in detail. SN - 2296-2360 UR - https://www.unboundmedicine.com/medline/citation/32582581/Successful_Treatment_of_Cyst_Infection_in_an_Infant_With_Autosomal_Dominant_Polycystic_Kidney_Disease_Using_Trimethoprim/Sulfamethoxazole L2 - https://doi.org/10.3389/fped.2020.00216 DB - PRIME DP - Unbound Medicine ER -
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