Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: September 30, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Acute Interstitial Nephritis (AIN)

Single most likely diagnosis

  • Vancomycin-induced AIN: The significant increase in creatinine levels (from 82 to 595) coincides with the administration of vancomycin, and the trough levels are elevated (11.7 and 49.5), which increases the risk of nephrotoxicity. Vancomycin is a well-known cause of AIN, especially with high trough levels.

Other Likely diagnoses

  • Cephalosporin-induced AIN: The patient received multiple cephalosporins (Cephalexin, Cefazolin, Ceftriaxone), which can also cause AIN. Although the temporal relationship is not as strong as with vancomycin, cephalosporins are a possible cause.
  • Piptazobactam-induced AIN: Piptazobactam is a broad-spectrum antibiotic that can cause AIN, although it is less common. The patient received pip-tazo (piperacillin-tazobactam) from September 25-28, which could contribute to the development of AIN.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

  • Sepsis-induced Acute Kidney Injury (AKI): Although the patient received multiple antibiotics, sepsis can cause AKI, which may present similarly to AIN. It is essential to rule out sepsis as a cause of AKI, as it requires prompt and aggressive treatment.
  • Rhabdomyolysis: Rhabdomyolysis can cause AKI and may be related to the patient's underlying condition or medication use. It is crucial to consider this diagnosis, as it requires specific treatment and can have severe consequences if missed.

Rare diagnoses

  • Other medication-induced AIN: Other medications, such as NSAIDs or diuretics, can cause AIN, although they are not mentioned in the provided history.
  • Intrinsic renal disease: Pre-existing renal disease, such as glomerulonephritis or vasculitis, can cause AKI and may be unrelated to the patient's medication use. However, this is less likely given the temporal relationship between antibiotic use and the development of AKI.

Related Questions

What is the approach for managing hypoglycemia using a continuous glucose infusion?
What is the role of mechanical power in pediatric mechanical ventilation?
Is cupping effective as a treatment for medical conditions?
What is the most potent nonsteroidal anti-inflammatory (NSAID) medication?
Is Solifenacin Succinate (overactive bladder medication) safe to use with oral Minoxidil (hypertension/alopecia treatment)?
What are some natural aids for anxiety?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question