Unusual case presentation of Ertapenem induced Acute Interstitial Nephritis (AIN) in a case of Protein S deficiency and factor V leiden mutation with Deep Vein Thrombosis

Abstract

Interstitial nephritis is a usually short-term disorder. In rare cases, it can cause permanent damage, including chronic kidney failure. Acute interstitial nephritis may be more severe and more likely to lead to long-term or permanent kidney damage in elderly people, if not diagnosed early. Acute Interstitial Nephritis (AIN) is known to occur following analgesics and certain antibiotics. We present a case of 58 years old male patient, who presented with high fever for which injection Ertapenem was started empirically at Dubai hospital. Patient was a known case of Deep Vein thrombosis of left leg since 5 years on warfarin therapy. Patient came to India for high fever and further management. Patient developed proteinuria with high creatinine and urinary abnormalities. Renal biopsy revealed Acute interstitial Nephritis (AIN). In addition, he was diagnosed to have Protein S deficiency with Factor V Leiden mutation.