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73歳女性。以前より両側多発性単純性腎嚢胞を指摘されていた。右側腹部痛,発熱を主訴に初診した。右腎盂腎炎として加療したが改善しなかった。超音波検査で右腎下極の嚢胞に内容物を認め,化膿性嚢胞を疑い経皮的穿刺術を施行した。下極の嚢胞からの排液は黄色透明であったが中央部の嚢胞から膿が排出された。穿刺後,化膿性嚢胞内に塩酸ミノサイクリン計400mgを注入した。穿刺後3か月で再発は認めず,CT上嚢胞は消失した。
A 73-year-old woman, who had been diagnosed as having bilateral simple renal cyst three years before, was hospitalized because of right flank pain and high fever. A tentative diagnosis of acute pyelonephritis was made but the patient did not respond to antibiotics. Ultrasonogra-phy revealed an irregular echo pattern in a cyst located in the lower pole of kidney and percutaneous puncture of the cyst yielded clear-yellow fluid, therefore a cyst in the middle portion of the kidney was punctured and yielded 300 ml dark-yellow pus which contained E. coli.
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