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NDT Advance Access originally published online on October 12, 2005
Nephrology Dialysis Transplantation 2005 20(12):2820-2823; doi:10.1093/ndt/gfi183
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

Metastatic intracranial subdural empyema from renal cyst infection in autosomal dominant polycystic kidney disease

Hiroshi Nishi1, Yugo Shibagaki1, Shuji Hatakeyama2, Takafumi Ito3, Taiji Nagata4, Minoru Ohno5, Akihiro Tojo1, Masaomi Nangaku1 and Toshiro Fujita1

1 Department of Nephrology and Endocrinology, 2 Infectious Diseases, 3 General Internal Medicine, 4 Respiratory Medicine and 5 Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Correspondence and offprint requests to: Yugo Shibagaki, Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Email: eugo@wc4.so-net.ne.jp

Keywords: autosomal dominant polycystic kidney disease (ADPKD); cyst infection; Escherichia coli (E.coli); pulse-field gel electrophoresis (PFGE); subdural empyema

The first 10% of the full text of this article appears below.



   Introduction
 
Approximately 30–50% of patients with autosomal dominant polycystic kidney disease (ADPKD) develop renal infection [1]. Cyst infection and acute pyelonephritis are the most common infectious complications, although bacteraemia, perinephric and extrarenal abscess can also be seen. The problem is that eradication of cyst infections with conventional antibiotics is sometimes unsuccessful chiefly because of poor penetration of antibiotics into infected cysts. As a result, a significant portion of patients with ADPKD suffer from latent cyst infection, which may result in bacteraemia and/or metastatic extrarenal infection.

We describe here a case of ADPKD whose intracranial subdural empyema indicated a metastatic abscess from an uncontrolled cyst infection accompanying ADPKD.



   Case
 
A 76-year-old woman was admitted for sudden onset of fever and altered mental status in June 2005. The patient . . . [Full Text of this Article]



   Discussion
 

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