Candida albicans and Staphylococcus lugdunensis superinfection of liver cysts in a patient with autosomal dominant polycystic kidney disease under prednisolone treatment

CEN Case Rep. 2020 Nov;9(4):370-374. doi: 10.1007/s13730-020-00488-4. Epub 2020 May 21.

Abstract

We report a case of superinfection of liver cysts caused by Candida albicans and Staphylococcus lugdunensis in a patient with autosomal dominant polycystic kidney disease. A 69-year-old man with chief complaints of headache and blurred vision was admitted to the former institution for the evaluation of suspected temporal arteritis. He was prescribed oral prednisolone (55 mg/day) as a preemptive treatment; however, he became febrile and presented with bilateral flank pain during prednisolone tapering. Blood culture revealed fungemia as a result of Candida famata infection; thus, micafungin treatment was started. Thereafter, recrudescence of the C-reactive protein level ensued. Then a cyst infection as visualized on magnetic resonance imaging led to cyst aspiration sclerotherapy. Cyst aspirate culture revealed the presence of C. albicans in one of the cysts and S. lugdunensis in two of the cysts. The patient was clinically stabilized with an additional 3 weeks of antibiotic and antifungal drug administration.

Keywords: Autosomal dominant polycystic kidney disease; Candida albicans; Candida famata; Cyst infection; Double infection; Staphylococcus lugdunensis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Candida albicans / isolation & purification*
  • Cysts / diagnosis
  • Cysts / microbiology*
  • Diffusion Magnetic Resonance Imaging / methods
  • Giant Cell Arteritis / diagnosis
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Liver / pathology
  • Male
  • Polycystic Kidney, Autosomal Dominant / complications
  • Polycystic Kidney, Autosomal Dominant / drug therapy*
  • Prednisolone / administration & dosage
  • Prednisolone / therapeutic use
  • Staphylococcus lugdunensis / isolation & purification*
  • Superinfection / drug therapy*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • Glucocorticoids
  • Prednisolone