萬古黴素引起急性間質性腎炎：一病例報告及文獻回顧

Acute Interstitial Nephritis Associated with Vancomycin Therapy in Septic Arthritis: A Case Report

本篇報告描述一位五十歲男性因感染性關節炎接受萬古黴素治療而造成急性間質性腎炎的病例。此急性間質性腎炎的臨床表現非常典型，包括發燒，皮膚紅疹，血中嗜伊紅性白血球增加及急性腎功能衰竭。腎臟病理切片亦証實是急性間質性腎炎。經過停用藥物及口服類固醇治療。病患腎功能完全恢復，皮膚紅疹也都消退。本病例是文獻中第七例經由病理切片證實使用萬古黴素引起急性間質性腎炎。籍由此一病例及文獻回顧，醫者應注意藥物引起急性間質性腎炎的早期診斷及早期治療。

Vancomycin-induced acute interstitial nephritis has been rarely reported. Here, we present a 50-year-old man with septic arthritis who developed acute renal failure after vancomycin therapy. The clinical presentations of this patient were fever, skin rash, peripheral eosinophilia, and acute renal failure. After admission, renal biopsy was done and the pathology revealed acute interstitial nephritis. After discontinuation of the offending agent and use of systemic corticosteroid therapy, his renal function recovered completely. This is the seventh report of biopsy-proved vancomycin-induced acute interstitial nephritis in the literature. The clinical manifestations, diagnosis, and treatment of drug-induced acute interstitial nephritis are discussed.