Acute Renal Failure With Ciprofloxacin Overdose: Spectrum of Renal Pathology

Ciprofloxacin is a commonly used fluoroquinolone despite evidence of increased resistance.

Acute interstitial Nephritis secondary to ciprofloxacin usage is a well-known entity at therapeutic dosages. Literature review shows scant reports of renal failure secondary to overdose of ciprofloxacin.

Here we report a 50 year old male patient who presented as an emergency with anuria and renal failure 4 days after ingestion of 20 tablets of ciprofloxacin. Renal biopsy revealed granulomatous interstitial nephritis, acute tubular necrosis and crystals in the tubular lumen.

Acute Interstitial nephritis is the most common biopsy feature of Ciprofloxacin induced renal failure. Isolated findings of acute tubular necrosis, granulomatous interstitial nephritis and crystals in the tubular lumen have also been reported. This case is unique for the presence of all three pathological findings.