Objectives: We present a case of adult polycystic kidney disease, also known as autosomal dominant polycystic kidney, complicated by infection of the cysts and the formation of gas within them.

Methods/results: A 59 year old patient diagnosed of adult polycystic kidney disease with chronic renal failure on treatment with haemodialysis, who presented sepsis secondary to infection of the renal cysts. The CT scan demonstrated the presence of gas within the cysts and the microbiology revealed E. coli in one of them. Urgent nephrectomy was performed. A histological specimen of the excised organ is also presented.

Conclusions: Infection of one or more cysts in adult polycystic kidney disease is a rare and serious complication which may require immediate nephrectomy, particularly if gas appears within the cysts.

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