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Cefepime induced acute interstitial nephritis – a case report

BACKGROUND: Nephrotoxicity due to drugs especially beta lactams and cephalosporins has been well recognised. Cefepime is a fourth-generation cephalosporin that is widely prescribed with few severe adverse reactions reported. Although cefepime induced neurotoxicity has frequently been reported, there...

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Autores principales: Mac, Kathy, Chavada, Ruchir, Paull, Sharon, Howlin, Kenneth, Wong, Jeffrey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359532/
https://www.ncbi.nlm.nih.gov/pubmed/25886295
http://dx.doi.org/10.1186/s12882-015-0004-x
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author Mac, Kathy
Chavada, Ruchir
Paull, Sharon
Howlin, Kenneth
Wong, Jeffrey
author_facet Mac, Kathy
Chavada, Ruchir
Paull, Sharon
Howlin, Kenneth
Wong, Jeffrey
author_sort Mac, Kathy
collection PubMed
description BACKGROUND: Nephrotoxicity due to drugs especially beta lactams and cephalosporins has been well recognised. Cefepime is a fourth-generation cephalosporin that is widely prescribed with few severe adverse reactions reported. Although cefepime induced neurotoxicity has frequently been reported, there is yet no reported case of acute interstitial nephritis caused by this drug. We report a biopsy proven case of acute kidney injury due to acute interstitial nephritis associated with use of cefepime for treatment of mastoiditis and temporal bone osteomyelitis. CASE PRESENTATION: A 62-year-old Caucasian female presented with symptoms of right sided mastoiditis. A brain Magnetic Resonance Imaging scan revealed presence of right sided mastoiditis with concurrent temporal bone osteomyelitis. Microbiological specimen isolated an Escherichia coli. Therapy was commenced with intravenous cefepime. After 4 weeks of therapy with intravenous cefepime she developed acute kidney injury. No other medications were taken by the patient. Urine analysis revealed non-nephrotic range proteinuria. There was no red cell casts or white cell casts. Renal biopsy confirmed acute interstitial nephritis as cause of acute kidney injury. Cefepime therapy was ceased and treatment with ciprofloxacin was given to complete the treatment course. Renal function improved only partially with conservative management without any corticosteroid use. To our knowledge this is the first report of cefepime induced interstitial nephritis. CONCLUSIONS: Although cefepime has been considered to be a safe antibiotic from nephrotoxicity point, like other cephalosporins this adverse effect can occur rarely. Physicians need to be mindful of nephrotoxicity associated with its use and careful monitoring of renal parameters should be performed in patients on prolonged therapy with cefepime.
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spelling pubmed-43595322015-03-15 Cefepime induced acute interstitial nephritis – a case report Mac, Kathy Chavada, Ruchir Paull, Sharon Howlin, Kenneth Wong, Jeffrey BMC Nephrol Case Report BACKGROUND: Nephrotoxicity due to drugs especially beta lactams and cephalosporins has been well recognised. Cefepime is a fourth-generation cephalosporin that is widely prescribed with few severe adverse reactions reported. Although cefepime induced neurotoxicity has frequently been reported, there is yet no reported case of acute interstitial nephritis caused by this drug. We report a biopsy proven case of acute kidney injury due to acute interstitial nephritis associated with use of cefepime for treatment of mastoiditis and temporal bone osteomyelitis. CASE PRESENTATION: A 62-year-old Caucasian female presented with symptoms of right sided mastoiditis. A brain Magnetic Resonance Imaging scan revealed presence of right sided mastoiditis with concurrent temporal bone osteomyelitis. Microbiological specimen isolated an Escherichia coli. Therapy was commenced with intravenous cefepime. After 4 weeks of therapy with intravenous cefepime she developed acute kidney injury. No other medications were taken by the patient. Urine analysis revealed non-nephrotic range proteinuria. There was no red cell casts or white cell casts. Renal biopsy confirmed acute interstitial nephritis as cause of acute kidney injury. Cefepime therapy was ceased and treatment with ciprofloxacin was given to complete the treatment course. Renal function improved only partially with conservative management without any corticosteroid use. To our knowledge this is the first report of cefepime induced interstitial nephritis. CONCLUSIONS: Although cefepime has been considered to be a safe antibiotic from nephrotoxicity point, like other cephalosporins this adverse effect can occur rarely. Physicians need to be mindful of nephrotoxicity associated with its use and careful monitoring of renal parameters should be performed in patients on prolonged therapy with cefepime. BioMed Central 2015-02-11 /pmc/articles/PMC4359532/ /pubmed/25886295 http://dx.doi.org/10.1186/s12882-015-0004-x Text en © Mac et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Mac, Kathy
Chavada, Ruchir
Paull, Sharon
Howlin, Kenneth
Wong, Jeffrey
Cefepime induced acute interstitial nephritis – a case report
title Cefepime induced acute interstitial nephritis – a case report
title_full Cefepime induced acute interstitial nephritis – a case report
title_fullStr Cefepime induced acute interstitial nephritis – a case report
title_full_unstemmed Cefepime induced acute interstitial nephritis – a case report
title_short Cefepime induced acute interstitial nephritis – a case report
title_sort cefepime induced acute interstitial nephritis – a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359532/
https://www.ncbi.nlm.nih.gov/pubmed/25886295
http://dx.doi.org/10.1186/s12882-015-0004-x
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