Table 4.

Clinical data for cases of acute interstitial nephritis (AIN) to vancomycin (n=8)

	Age (yrs)	Gender (m/f)	Infection treated	Reaction timing*	Symptoms	Lab data	Biopsy	Treatment	Outcome
Htike et al. 2012	79	F	Coagulase-neg Staphylococcus Bacteremia	7d	Malaise, fatigue	Cr (bl 0.9 mg/dL,max 11.7 mg/dL, 92.3% change) No urine eosinophils	ATN changes: Loss of tubular cells tubular dilatation AIN changes: Interstitial edema Eosinophils Mononuclear infiltrate	Oral steroids for 2 weeks	Renal function resolved over 4 weeks
Salazar et al. 2010	51	M	MRSA osteomyelitis	28d	Rash	Cr (bl 0.9 mg/dL, max 2.2,59.0% change) AEC: 2318/L	Interstitial edema Eosinophils Mononuclear infiltrations	Oral steroids	One recurrence Followed by resolution
Michail et al. 2009	35	M	S. aureus empyema	4d	MP rash, arthralgia	Cr (bl normal, max 6.5 mg/dL) No urine eoisinophils	Mononuclear inflammatory infiltration	Furosemide HD Switched therapy	Renal function resolved over 10m
Hong et al. 2007	44	M	Polymicrobial wound infection with Staphylococcus aureus, Group B Streptococci, and S.mitis	28d	Rash, fever, hypotensio n	Cr (bl 3.1 mg/dL, max 8.5 mg/dL, 63.5% change AEC: 640/L	Giant cell granulomas Mononuclear interstitial infiltration	After failed IV and oral steroids x 1w, switched to cyclosporine and MMF HD Switched therapy	Renal function improved with cyclosporine, MMF and HD for 2m
Hsu et al. 2001	70	M	MRSA abscess	23d	Fever, MP rash	Cr (bl 2.0 mg/dL, max 3.5 mg/dL,42.9 % change) AEC: 936	Interstitial edema Eosinophils Mononuclear infiltrations	Oral steroids CVVH Switched therapy	Several readmissions followed by death from polymicrobial sepsis
Wai et al. 1998	64	M	MRSA sternal wound dehiscence s/p CABG	39d	Fever, MP rash	Cr (bl 1.1 mg/dL,max 9.5 mg/dL,88.4 % change) AEC: 979/L	Interstitial mononuclear infiltrations Granulomata	Oral steroids HD over 2 weeks Switched therapy	Renal function improved Several readmissions and complicated post- operative course
Codding et al. 1989	67	M	Staphylococcus aureus endocarditis	30d	Fever, MP rash	Cr (bl 1.5 mg/dL, max 6.6mg/dL) AEC: 861	Interstitial mononuclear infiltration Granulomata	HD Switched therapy	Clinically deteriorated Deceased from septic shock
Bergman et al. 1988	34	F	Endometritis, Staphylococcus aureus	6d	Fever, pedal edema	Cr (bl 1.5 mg/dL,max 3.4 mg/dL) AEC: normal	Refused renal biopsy	Discontinued vancomycin	Renal function resolved within 15 days

^*Timing from vancomycin dose to reaction onset

Abbreviations: d: days; Cr: Creatinine; bl: baseline; max: maximum; ATN: acute tubular nephrosis; AIN: allergic interstitial nephritis; MRSA: methicillin-resistant Staphylococcus aureus; AEC: absolute eosinophil count; MP: maculopapular; HD: hemodialysi; IV: intravenous; w: weeks; MMF: mycofenolate mofetil; m: months; CVVH: continuous-veno-venous hemofiltration; s/p: status-post; CABG: coronary artery by-pass graft