Biochemical and Pharmacodynamic Studies of Simple Renal Cyst Fluids in Relation to Infection

Abstract

Biochemical analysis of renal cyst fluid was performed in 53 patients with simple renal cysts including 2 infected cases. The composition of noninfected cyst fluid tended to parallel that of serum. Additionally, the penetration of amikacin into cyst fluid was studied in 2 infected and in 11 noninfected patients following a single 200-mg intramuscular injection of amikacin. Drug levels in the fluid were below detection limit in the noninfected and approximately half or less of the serum values in the infected patients. These data may explain one of the reasons why infection of simple renal cysts is highly resistant to antimicrobial chemotherapy. The value of treatment by percutaneous aspiration and drainage of infected cysts is emphasized.

Simulated Cystic Renal Lesions: Quantitative X-ray Phase-Contrast CT—An in Vitro Phantom Study

“…On the basis of the results of previous studies, the cyst phantoms simulated simple nonenhancing, proteinrich, hemorrhagic cysts and enhancing (malignant) cystic lesions (13)(14)(15)(16). To simulate nonenhancing, protein-rich cysts, mixtures of untainted human serum and normal saline (sodium chloride, 0.9%; B. Braun, Melsungen, Germany) with 100% saline, 75% saline and 25% serum, 50% saline and 50% serum, 25% saline and 75% serum, and 100% serum were used.…”

Renal Cysts and Urinomas

“…If infected, cyst drainage is valuable because some antibiotics do not penetrate into cyst fluid even when the cyst wall is inflamed. 20 Cyst drainage may be used to initiate therapy or as a diagnostic trial to see if it eliminates the symptoms.…”

Renal actinomycosis presenting as a suppurated solitary cyst

“…Although Actinomyces species appear to be susceptible to a wide range of beta-lactam agents which, combined with beta-lactamase inhibitors are regarded as agents of first choice, it is well known that infected simple SRCs are highly resistant to antimicrobial chemotherapy due to poor antibiotic penetration. [5] Therefore, it is unknown whether in our case high doses of penicillin alone could have been curative considering the septic status of the patient and the pharmacokinetic properties of beta-lactam agents in simple SRCs.…”