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Published on: July 18, 2017
Four cases of nafcillin-associated acute interstitial nephritis in one institution
Tobin Hoppes1, Marios Prikis, Alan Segal
1University of Vermont/FAHC, Department of Medicine, Division of Nephrology, Colchester, VT 05446, USA.
Background:
Over the course of 1 year, four patients in a single institution developed acute kidney injury most likely secondary to nafcillin-associated acute interstitial nephritis, indicating that this complication might not be as rare as is commonly believed. The main case presented here is that of a 73-year-old man with a history of chronic low back pain who presented with worsening back pain, as well as nausea, vomiting and volume depletion. Imaging studies revealed a soft tissue abscess in the left psoas major muscle.
Investigations:
Physical examination, complete urine analysis, blood and urine cultures, measurement of peripheral eosinophil and plasma creatinine levels, and renal ultrasound.
Diagnosis:
Nafcillin-associated acute interstitial nephritis.
Management:
Discontinuation of nafcillin and provision of supportive care.
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