A 35-year-old woman is treated for bacterial pharyngitis with ampicillin. 5 days later, the patient presented to the emergency department with a fever and skin rash. She noticed decreased urine output. Temperature is 38.5 C (101.3 F), blood pressure is 132/81 mm Hg, and pulse is 88/min. On examinations, she has a diffuse maculopapular rash. Serum creatinine level is 2.5 mg/dL, and urine sediment microscopy reveals 5-6 red blood cells/HPF, 10-15 white blood cells/hpf, and 3-5 eosinophils/hpf. The pathologic process affecting this patient's kidneys most likely involves one of the following structures?

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Quizplus · Accepted Answer

Eductional Objective: Acute interstitial nephritis presents 1-3 weeks after new medications. Patients present with fever, maculopapular rash, and acute renal failure. Laboratory studies show eosinophiluria, sterile pyuria, and eosinophilia. White blood cell casts could be seen on urinalysis microscopy. Microscopic investigation shows leukocyte infiltration and edema on the renal interstitium.

A 35-Year-Old Woman Is Treated for Bacterial Pharyngitis with Ampicillin