Refractory salmonella enterica serotype choleraesuis-related renal cyst infection in a patient with autosomal dominant polycystic kidney disease undergoing hemodialysis treated successfully with intracystic ciprofloxacin infusion

To report a potential salvage therapy for refractory renal cyst infection secondary to Salmonellaenterica serotype choleraesuis [S. choleraesuis].Clinical Presentation and Intervention: A 52-year-old male with autosomal dominant polycystic kidney disease undergoing hemodialysis experienced an episode of S. choleraesuis-related gastroenteritis subsequently complicated by bloodstream and refractory renal cyst infection with formation of multiple pyocysts. The patient was treated with intracystic indwelling diluted ciprofloxacin solution. In this patient, intracystic infusion of ciprofloxacin achieved a sufficient antibiotic level in infected renal cysts and hence completely eradicated S. choleraesuis. Therefore, intracystic antiobiotic infusion could be a potential salvage therapy for refractory renal cyst infection

Low-molecular-weight heparin successfully used to treat a nephrotic patient complicated by superior mesenteric vein thrombosis and portal vein thrombosis

To report the success of treatment with low-molecular-weight heparins [LMWHs] in a case of nephrotic syndrome complicated by mesenteric vein thrombosis [MVT] and portal vein thrombosis [PVT]. A 53-year-old man with nephrotic syndrome developed persistent mild abdominal pain for 3 days. Hepatic-portal venous system thrombosis of nephrotic syndrome was suspected due to new-onset superficial vein engorgement of the abdomen without liver cirrhosis. Abdominal computed tomography revealed MVT concomitant with PVT. He was successfully treated with LMWH without thrombolytic therapy. After discharge on day 9, he received continuous anticoagulation by LWMH on an outpatient basis at the nephrology clinic. Venous thromboembolic events or proteinuria did not recur within the 6-month follow-up. This report showed a case of MVT concomitant with PVT, a critical complication of nephrotic syndrome that was diagnosed in time and successfully treated with LMWH. A high index of clinical suspicion and timely management are crucial to tackle thrombotic complications in nephrotic syndrome

Acute pyelonephritis associated with transudative pleural effusion in a middle-aged women without urinary tract obstruction

To describe a case of acute pyelonephritis associated with pleural effusion. A 39-year-old female non-smoker who had Escherichia coli bacteremia due to acute pyelonephritis, developed bilateral transudative pleural effusions during hospitalization. She was successfully treated with intravenous antibiotic therapy. Follow-up chest radiographs revealed complete resolution of the bilateral pleural effusions. Though quite rare, pleural effusion is a potential complication of acute pyelonephritis. The exact pathogenesis of transudative pleural effusion is unknown, but the effusion may resolve spontaneously when infection is adequately controlled