SARS-CoV-2 (COVID-19) is well known to have extrapulmonary manifestations, including acute renal failure. While radiologic findings of COVID-19 pulmonary-involvement have been described, renal findings associated with COVID-19 have not. We present a case of a 38-year-old Afro-Caribbean female diagnosed with COVID-19 whose renal ultrasound showed increased parenchymal echogenicity, decreased global color Doppler signal with elevated resistive indices, but no large vessel thrombi. Non-targeted renal biopsy demonstrated collapsing focal segmental glomerulosclerosis (FSGS), likely secondary to COVID-19 infection, which may be a specific manifestation of this disease that has been predominantly reported in Black patients. We report several findings on renal ultrasound with duplex Doppler not previously associated with COVID, specifically with FSGS, which in conjunction can be useful to both the radiologist and the clinician, potentially pointing them in the direction of this diagnosis and early treatment.

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Purpose: To identify risk factors for chest port (port) infections in patients with solid cancers. Materials: A retrospective chart review of 1158 adult patients (18 years old) with solid cancers (male/female: 551/607, mean age: 58.1 years) who had a port placed between January 2012 and December 2015 was conducted to identify patients port infections. Port placement was generally avoided in patients with severe neutropenia (absolute neutrophil count or ANC<500/μL). The most frequent site of cancer was lung (n ¼ 258, 22.3%) followed by breast (n ¼ 240, 20.7%). Port infections included port site (local) and blood stream infections. The patients were divided into two groups based on the records of port infections (infection vs non-infection). Variables including the patients' demographics, medical history, laboratory data at the time of port placement, medication used, and port characteristics were compared between groups. To elucidate risk factors for port infections, multivariate proportional subdistribution hazard regression analyses were performed. Results: A total of 389,815 catheter-days (median per patient: 522 catheter-days) were observed. Port infections were identified in 80 patients (6.9%) including 45 with port-site, 27 with bloodstream, and 8 with both. The infection rate was 0.21/1000 catheter-days. The median time to infection was 244 days (Range, 11-828 days). The infection group had significantly more patients with history of prior port placement (p ¼ .01) and use of double lumen port (P ¼ .001), and significantly shorter median duration of follow-up (P ¼ .001) compared to the non-infection group. In backward stepwise multivariate analyses, prior port placement (p ¼ 0.03, HR ¼ 2.23, 95% CI [1.08-4.62]), use of double-lumen port (p ¼ 0.01, HR ¼ 2.08, 95% CI [1.15-3.74]) thrombocytopenia (platelet count<150,000/μL) (p ¼ 0.01, HR ¼ 2.16, 95% CI [1.19-3.90]) remained statistically significant. Neutropenia (ANC<1500/μL) was not the risk factor. Conclusions: Solid cancer patients with thrombocytopenia or a history of prior port need to be closely monitored for port infections. A single lumen port would be advised in these subgroups.

This study compared the 30-day infection risk of chest ports accessed on the same day as placement and chest ports with delayed initial access. The aim was to evaluate a larger data set that provided evidence for the development of port access guidelines. A retrospective chart review of 3322 chest port placement procedures performed between October 15, 2003, and June 10, 2015, was conducted at the interventional radiology department of a single institution. Procedure notes and health records were reviewed to determine time of initial port access, evidence of infection within a 30-day window of port placement, and causal organism(s) of infection. The results demonstrated that 64 ports (1.93%) met infection criteria within 30 days of placement, including 30 of the 945 ports immediately accessed and 34 of the 2377 ports not immediately accessed (3.17% vs 1.43%; P < .005). Dual lumen devices had a statistically significant higher rate of infection compared with single lumen devices (P = .006). This study concluded that there is a statistically significant higher rate of infection if a port is accessed immediately versus when access is deferred to later than 24 hours after placement.