title: Piperacillin-Tazobactam Induced Interstitial Nephritis, Hepatitis and Serum Sckness-Like Illness.
abstract: OBJECTIVE
  To describe a patient who developed acute interstitial nephritis, hepatitis and serum sickness-like syndrome after receiving piperacillin-tazobactam (zosyn) therapy.
  
  
  METHODS
  A 30-year-old woman received a 7-day course of piperacillin-tazobactam as empiric treatment for pneumonia. The patient's kidney function worsened and she turned anuric needing dialysis. She also developed fever and a rash. Laboratory analysis showed elevated liver function and leukocytosis. Kidney biopsy showed acute interstitial nephritis. The patient responded well to steroids; white blood cell count normalized and her liver and kidney function improved over a period of one month.
  
  
  CONCLUSIONS
  Piperacillin-tazobactam is one of the most commonly used antibiotics in the hospital setting. It has rarely been associated with acute interstitial nephritis, hepatic injury, or serum sickness-like reactions. Steroids have improved the outcome in most of the cases of interstitial nephritis.
  
  
  CONCLUSIONS
  Clinicians should be aware of piperacillin-tazobactam as a drug capable of causing interstitial nephritis, hepatitis and serum sickness-like syndrome. It is essential that we monitor for these rare but severe complications.
authors.forename: Shashank
authors.initials: S
authors.lastname: Kraleti
authors.forename: Nudrat
authors.initials: N
authors.lastname: Khatri
authors.forename: Diane
authors.initials: D
authors.lastname: Jarrett
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006801:Humans; D009395:Nephritis, Interstitial / Q000139:chemically induced*; D010397:Penicillanic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D010878:Piperacillin / Q000009:adverse effects; D000077725:Piperacillin, Tazobactam Drug Combination; D011014:Pneumonia / Q000188:drug therapy*; D012713:Serum Sickness / Q000139:chemically induced*
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin