Prolonged infusion of meropenem for suspected intracystic infection in polycystic kidney disease during pregnancy: a case report.

IF 3.6 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Frontiers in Medicine Pub Date : 2026-10-05 eCollection Date: 2026-01-01 DOI:10.3389/fmed.2026.1856558

Bingqing Ruan, Danjia Xie, Liangqi Yan, Nianying Deng

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Abstract

Background: Intrarenal cyst infection in polycystic kidney disease (PKD) is hard to confirm and harder to treat during pregnancy, when lipid-soluble antibiotics are generally avoided.

Case: A pregnant woman at approximately 10 weeks' gestation presented with recurrent fever and flank pain for over one month, with acute exacerbation one day prior to admission. Laboratory tests revealed progressively elevated C-reactive protein (CRP) levels despite repeatedly negative cultures. Serial ultrasound showed a right upper-pole renal cyst that evolved to exhibit internal septations and debris.

Treatment and outcome: Cyst aspiration was avoided; meropenem 1 g every 8 h was initiated on admission and converted to prolonged infusion (1 g infused over more than 3 h) on Day 4, followed by step-down oral amoxicillin-clavulanate, for a total antimicrobial course of 32 days. Fever resolved and CRP normalized; pregnancy continued uneventfully.

Conclusion: In a pregnant patient with suspected PKD cyst infection, prolonged-infusion meropenem was followed by clinical improvement. The favorable response observed supports further evaluation of this therapeutic strategy, despite the absence of microbiological confirmation.

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长期输注美罗培南治疗妊娠期多囊肾病疑似囊内感染1例

背景：妊娠期多囊肾病（PKD）肾内囊肿感染难以确诊，治疗难度较大，一般避免使用脂溶性抗生素。病例：一名妊娠约10周的孕妇，在入院前1天出现反复发热和腹部疼痛，持续1个多月。实验室检查显示c反应蛋白（CRP）水平逐渐升高，尽管反复阴性培养。连续超声显示右上极肾囊肿，发展为内部分隔和碎片。治疗和结果：避免了囊肿抽吸；入院时开始使用美罗培南1 g / 8 h，第4天转为延长输注（1 g输注超过3 h），随后逐步口服阿莫西林-克拉维酸酯，总抗菌疗程为32天。发热消退，CRP正常；怀孕继续平安无事。结论：1例疑似PKD囊肿感染的妊娠患者，长期输注美罗培南后临床好转。观察到的良好反应支持进一步评估这种治疗策略，尽管缺乏微生物证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Medicine Medicine-General Medicine

CiteScore

5.10

自引率

5.10%

发文量

3710

审稿时长

12 weeks

期刊介绍： Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world