Biopsy proven interstitial nephritis following treatment with vancomycin: a case report.

Acute interstitial nephritis is rarely reported with vancomycin. Literature searches revealed six biopsy-proven cases of vancomycin-induced interstitial nephritis. We report a case of a 51-year-old male who was treated with vancomycin and gentamicin for primary osteomyelitis with methicillin resistant Staphyloccocus aureus bacteremia.

Acute kidney injury, hyperosmolality and metabolic acidosis associated with lorazepam.

Background: A 54-year-old male with a history of multiple admissions for alcohol intoxication was admitted to hospital with right flank pain. He received a high-dose lorazepam infusion for alcohol withdrawal during hospitalization and developed severe hyperosmolality, high anion gap metabolic acidosis, and acute kidney injury on his eighth day of hospitalization.

Investigations: Serum chemistries, arterial blood gas analysis, and measurement of serum propylene glycol, ethylene glycol and methanol levels.

Recognition, treatment, and prevention of propylene glycol toxicity.

Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. Although it is considered safe, large intravenous doses given over a short period of time can be toxic. Underlying renal insufficiency and hepatic dysfunction raise risk for toxicity.