J Korean Med Sci.  2015 Jan;30(1):110-114. 10.3346/jkms.2015.30.1.110.

Megalocytic Interstitial Nephritis Following Acute Pyelonephritis with Escherichia coli Bacteremia: A Case Report

• Kwon HJ
• Yoo KH
• Kim IY
• Lee S
• Jang HR
• Kwon GY

• KMID: 2155455
• DOI: http://doi.org/10.3346/jkms.2015.30.1.110

Abstract

Megalocytic interstitial nephritis is a rare form of kidney disease caused by chronic inflammation. We report a case of megalocytic interstitial nephritis occurring in a 45-yrold woman who presented with oliguric acute kidney injury and acute pyelonephritis accompanied by Escherichia coli bacteremia. Her renal function was not recovered despite adequate duration of susceptible antibiotic treatment, accompanied by negative conversion of bacteremia and bacteriuria. Kidney biopsy revealed an infiltration of numerous histiocytes without Michaelis-Gutmann bodies. The patient's renal function was markedly improved after short-term treatment with high-dose steroid.

Keyword

Acute Kidney Injury; Megalocytic Interstitial Nephritis; Interstitial Nephritis

MeSH Terms

Acute Disease
Acute Kidney Injury/complications/*drug therapy/pathology
Anti-Bacterial Agents/therapeutic use
Azithromycin/therapeutic use
Bacteremia/*drug therapy/microbiology/pathology
Cefotaxime/therapeutic use
Creatinine/blood
Escherichia coli
Escherichia coli Infections/*drug therapy/microbiology/pathology
Female
Humans
Kidney/pathology
Methylprednisolone/therapeutic use
Middle Aged
Nephritis, Interstitial/*drug therapy/immunology/pathology
Pyelonephritis/complications/*drug therapy/pathology
Renal Dialysis
Shock, Septic/drug therapy/microbiology
Anti-Bacterial Agents
Azithromycin
Cefotaxime
Creatinine
Methylprednisolone