rifampin and Flank-Pain

We present an interesting case of Legionnaires' disease masquerading as acute pyelonephritis, with complete absence of respiratory symptoms on admission. A 45-year-old man was diagnosed with Legionnaires' disease 2 days after presenting to hospital with dysuria and right loin pain. He became critically unwell during the hospital admission, with headache, uncontrolled fever, breathlessness, decreasing oxygen saturations and increasing oxygen requirements. A CT pulmonary angiography demonstrated right upper lobar consolidation and Legionella urinary antigen was positive. He was treated with ciprofloxacin and rifampicin and made a full recovery.

Topics: Anti-Bacterial Agents; Antigens, Bacterial; Ciprofloxacin; Community-Acquired Infections; Diagnosis, Differential; Dysuria; Flank Pain; Humans; Legionnaires' Disease; Male; Middle Aged; Pneumonia; Pyelonephritis; Rifampin

A 49-year-old man with a medical history of polycystic kidney disease was presented to the emergency department with fever and left flank pain. Abdominal examination revealed an enlarged and painful left kidney. The C-reactive protein level was significantly high and the magnetic resonance imaging revealed areas of abnormal intensity and fluid-fluid levels in renal cysts. Brucella abortus was yielded from both blood and cyst fluid culture. Standard therapy (rifampicin plus doxycycline) of brucellosis was started, but the clinical and laboratory signs subsided after the addition of ciprofloxacin. There was no need for aspiration of infected cyst fluid. Hereby, according to the medical database search, we report that the first renal cyst infection caused by B. abortus was successfully treated with triple antibiotic therapy.

Topics: Brucella abortus; Brucellosis; Ciprofloxacin; Doxycycline; Drug Therapy, Combination; Emergency Service, Hospital; Flank Pain; Follow-Up Studies; Humans; Infusions, Intravenous; Magnetic Resonance Imaging; Middle Aged; Polycystic Kidney Diseases; Rifampin; Treatment Outcome