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Four cases of nafcillin-associated acute interstitial nephritis in one institution

Abstract

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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Figure 1: Photomicrographs of urine sediment showing white blood cell casts
Figure 2: Plots of daily serum creatinine values

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Correspondence to Marios Prikis.

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The authors declare no competing financial interests.

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Hoppes, T., Prikis, M. & Segal, A. Four cases of nafcillin-associated acute interstitial nephritis in one institution. Nat Rev Nephrol 3, 456–461 (2007). https://doi.org/10.1038/ncpneph0561

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  • DOI: https://doi.org/10.1038/ncpneph0561

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