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Infected renal cystic mass associated with bacterial meningitis: a case report
1Department of Urology, Tatsunokuchi Houju Memorial Hospital, Ishikawa, Japan.
Abstract:
We report a case of an infected renal cystic mass associated with bacterial meningitis in a 70-year-old woman who had had poorly-controlled diabetes mellitus for approximately 30 years. She suffered from bacterial meningitis due to Klebsiella pneumoniae, which was successfully treated with antimicrobial chemotherapy for 1 month. Approximately 2 weeks later she developed left flank pain and a high fever. A CT scan and an ultrasonogram revealed a left renal cystic mass, which was considered to be an infected renal cyst. Turbid and thick fluid was obtained by percutaneous aspiration which contained numerous white blood cells. Culture of this fluid yielded K. pneumoniae. The bacterial meningitis was considered to be a secondary infection of the septicemia which resulted from the infected renal cystic mass.
Insights
A 70-year-old woman with diabetes experienced bacterial meningitis caused by Klebsiella pneumoniae. This infection likely originated from a secondary infected renal cyst, highlighting a rare complication in diabetic patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Diabetology
Background:
- Poorly controlled diabetes mellitus (DM) is a significant risk factor for various infections.
- Bacterial meningitis, while serious, can sometimes be secondary to other infections.
- Renal cystic masses are relatively common, but infection within them is less frequent.
Observation:
- A 70-year-old female patient with a 30-year history of poorly controlled diabetes presented with bacterial meningitis due to Klebsiella pneumoniae.
- Following successful treatment for meningitis, the patient developed symptoms of a left renal issue, including flank pain and fever.
- Imaging studies (CT and ultrasonogram) identified a left renal cystic mass.
Findings:
- Percutaneous aspiration of the renal cyst yielded turbid, thick fluid with numerous white blood cells.
- Culture of the aspirated fluid confirmed the presence of Klebsiella pneumoniae.
- The patient's initial bacterial meningitis was determined to be a secondary complication of septicemia originating from the infected renal cyst.
Implications:
- This case underscores the potential for infected renal cysts to act as a primary source of systemic infection, such as bacterial meningitis, particularly in immunocompromised individuals like those with poorly controlled diabetes.
- It highlights the importance of considering and investigating potential occult sources of infection in patients with recurrent or severe bacterial infections.
- Prompt diagnosis and management of infected renal masses are crucial to prevent severe systemic complications and improve patient outcomes.