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May 14, 2018

Diagnose This! (May 14, 2018)

What is your diagnosis? 

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The images show lymphocytic tubulitis as well as an eosinophil-rich interstitial inflammatory infiltrate. These findings are consistent with acute interstitial nephritis. The eosinophil-rich nature of the infiltrate is compatible with a drug/hypersensitivity reaction which was present in this patient, occurring from recent antibiotics exposure with subsequent acute renal failure and development of a rash.