A 58-year-old Hispanic man with diabetes complicated by recent toe amputations presented with worsening drainage of a toe wound. Three days prior to presentation, he completed a 7-day course of levofloxacin for treatment of community-acquired pneumonia, and his pneumonia symptoms had resolved. On physical examination, he was afebrile, hemodynamically stable, euvolemic, and had no skin eruptions. Laboratory test results were notable only for an elevated creatinine level of 6.7 mg/dL from a normal baseline. He did not note any recent changes in urine output, color, or consistency. His only new prescription was the levofloxacin, and he had not taken any over-the-counter medications, including nonsteroidal anti-inflammatory drugs.
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Strasma A, Kulkarni SA. Overuse of Urine Eosinophils in the Diagnosis of Acute Interstitial Nephritis: A Teachable Moment. JAMA Intern Med. Published online June 10, 2019179(8):1131–1132. doi:10.1001/jamainternmed.2019.1755
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