Overview
Cortical cystic disease encompasses infections within renal and hepatic cysts, often leading to severe complications requiring hospitalization despite empirical diagnosis due to limited cyst aspirates 1.Diagnosis
Clinical Presentation: Abdominal pain, fever, and elevated serum inflammatory markers are common 1.
Microbiological Findings: Urine and blood cultures often yield negative results, even in confirmed cases 1.
Imaging Modalities: (18)Fluorodeoxyglucose positron-emission tomography/computed tomography ((18)F-FDG PET/CT) shows promise for diagnosing cyst infections 1.
Diagnostic Criteria: Definite diagnosis criteria are consistent across studies, while probable criteria vary significantly 1.Management
Empiric Antibiotics: Initial treatment often involves broad-spectrum antibiotics pending culture results 1.
Targeted Therapy: Adjust antibiotic choice based on culture and sensitivity results when available 1.
Surgical Intervention: May be necessary for definitive treatment, particularly in refractory cases or complications 1.Special Populations
No Specific Guidance: The provided abstracts do not offer specific recommendations for pregnancy, pediatrics, elderly patients, or those with comorbidities 1.Key Recommendations
Utilize clinical symptoms (abdominal pain, fever, elevated inflammatory markers) and imaging with (18)F-FDG PET/CT for diagnosing cyst infections (Evidence: Moderate) 1.
Initiate empirical broad-spectrum antibiotic therapy and tailor based on microbiological findings (Evidence: Moderate) 1.
Consider surgical intervention for severe or refractory cases (Evidence: Expert opinion) 1.References
1 Lantinga MA, Drenth JP, Gevers TJ. Diagnostic criteria in renal and hepatic cyst infection. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2015. link