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[Obstructive renal insufficiency caused by amoxicillin crystalluria]

M Boursas1, L Benhassine, J Kempf

  • 1Fédération d'anesthésie-réanimation-Smur, centre hospitalier, Haguenau, France.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1997
PubMed
Summary

Listeria meningitis treatment with amoxicillin and gentamicin led to acute kidney injury due to amoxicillin-induced crystalluria. Prompt intervention with double-J catheters successfully restored renal function.

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Area of Science:

  • Infectious Diseases
  • Nephrology
  • Pharmacology

Background:

  • Listeria monocytogenes can cause severe infections like meningitis and rhombencephalitis.
  • Treatment regimens for Listeria infections often involve antibiotics such as amoxicillin and gentamicin.
  • Acute kidney injury (AKI) is a potential complication of certain antibiotic therapies.

Observation:

  • A 76-year-old female patient developed meningitis with rhombencephalitis due to Listeria monocytogenes.
  • The patient received amoxicillin and gentamicin for treatment.
  • Post-treatment, the patient presented with macroscopic hematuria, milky urine, and acute renal failure.

Findings:

  • Diagnostic imaging (CT scan, sonography) revealed obstructive renal failure with bilateral ureteral obstruction.

Related Experiment Videos

  • Amoxicillin crystalluria was identified as the suspected cause of the obstruction.
  • The patient's renal function normalized after endoscopic ureteral insertion of double-J catheters.

    • Implications:

    • This case highlights a rare but serious adverse effect of amoxicillin therapy.
    • Early recognition of crystalluria is crucial for managing antibiotic-induced nephrotoxicity.
    • Urgent urological intervention can effectively manage obstructive nephropathy and preserve renal function.