Management of an infected simple renal cyst by percutaneous aspiration

Percutaneous renal cyst puncture under fluoroscopic control has gradually become accepted as the definitive step in the diagnosis of uncomplicated simple cyst of the kidney (Sherwood and Stevenson, 1971; Lalli, 1972; Thornbury, 1972) and may succeed as a therapeutic manoeuvre (De Weerd, 1962) although few cysts actually require treatment. This paper describes the extension of this procedure to the diagnosis and treatment of infection of a simple renal cyst. A 55-year-old woman was admitted to hospital in diabetic precoma. Previously, her diabetes had been well controlled by oral Diabenese. After her resuscitation with intravenous fluids and insulin, she was found to have a pyrexia of 38°C, a leucocytosis of 15,000 per mm3, and slight tenderness in the right flank. Klebsiella aerogenes was cultured from the urine.