CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2014; 04(02): 129-132
DOI: 10.1055/s-0040-1703781
Case Report

PROLONGED PYREXIA WITH ACUTE RENAL INSULT - UNRAVELING THE PUZZLE AND SOLVING THE ENIGMA

Raghava Sharma
1   Professor, Department of Medicine, K. S. Hegde Medical Academy, Nitte University, Mangalore - 575 018, Karnataka, India
› Institutsangaben

Abstract:

A middle aged man with prolonged pyrexia was referred to us with a diagnosis of FUO (Fever of unknown origin). He was evaluated by various investigations and a diagnosis of Tuberculosis was established. On anti tubercular treatment (ATT) he developed complication of acute renal injury –non oliguric renal failure, from which he recovered fully after the puzzle was successfully solved & managed accordingly. Even though he was proved to have rifampicin induced acute intersticial nephritis(AIN) by biopsy , he had varied & unconventional presentation like without oliguria, without peripheral blood eosinophilia, and more so particularly on the maiden administration of rifampicin. Thus our case highlights the importance of quickly establishing the cause for FUO, and also need for greater vigilance on part of physicians to solve unconventional presentations of complications arising out of treatment.



Publikationsverlauf

Artikel online veröffentlicht:
24. April 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References:

  • 1 Mishin vIu, Vasileva IA, Makieva VG, Kuzmina NV, Prikazchikova AV, Khoroshutina VV. Probl Tuberk Bolezn LegK. 2003; (7): 24-9
  • 2 Rajendraprasad, Mukerjee Pk. Rifampicin induced thrombocytopenia. Ind J Tuberc 1989; 36: 44-5
  • 3 Flynn CT, Rainford DJ, Elinor Hope. Acute renal failure & Rifampicin. Danger of unsuspected intermittent dosage. BMJ 1974; 2: 482
  • 4 Nessi H, Bonoldi GL, Redaelli B, Di Fillipo G. Acute renal failure after rifampicin : a case report & survey of the literature. Nephron 1976; 16: 148-53
  • 5 Jerome Rossert. Drug induced acute intersticial nephritis. Kidney international 2001; 60: 804-817
  • 6 Kim MJ, Heim M, Mayr M. Nephrol Dial Transplant 2010; 25(5): 1716-9
  • 7 Bassi L, Pernal G, Silvestri LG. Antibodies against rifampicin in patients with Tuberculosis after discontinuation of daily treatment. Am Rev Resp Dis 1976; 114: 1189-90
  • 8 Latus J, Amann K, Braun N, Alscher MD, Kimmel M. Tubulo intersticial nephritis in active Tuberculosis- a single centre experience. Clin Nephrol 2012; 78(4): 297-302
  • 9 Prakash J, Kumar NS, Saxena RK, Verma U. Acute renal failure complicating Rifampicin therapy. JAPI 2001; 49: 877-880