Cephalexin-induced acute tubular necrosis.
A 24-year-old woman with a history of penicillin allergy developed reversible acute renal failure after receiving cephalexin for 4 days. The patient experienced nausea, vomiting, diarrhea, pruritus, cough, and an elevated creatinine level of 2.2 mg/dl. The patient's creatinine level continued to rise, peaking at 5.3 mg/dl on hospital day 3. Nephrotoxic acute tubular necrosis was confirmed by electron microscopy. Within 1 month of discharge from the hospital, the patient's creatinine level decreased to 0.6 mg/dl. Although the renal injury most commonly associated with the cephalosporin class of antibiotics is allergic interstitial nephritis, currently available cephalosporins infrequently can cause direct tubular toxicity.
Longstreth
Kristen L
KL
Department of Pharmaceutical Services, St. Elizabeth Health Center, Youngstown, Ohio 44501-1790, USA. kristen_longstreth@hmis.org
Robbins
Steven D
SD
Smavatkul
Chanigan
C
Doe
Nathaniel S
NS
D000328:Adult; D002506:Cephalexin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007511:Ischemia; D007668:Kidney / Q000098:blood supply*; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced* / Q000175:diagnosis; D007687:Kidney Tubules, Proximal / Q000473:pathology*; D008854:Microscopy, Electron; D010612:Pharyngitis / Q000188:drug therapy
D002506:Cephalexin