Telavancin-associated acute kidney injury
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Telavancin is a lipoglycopeptide semi-synthetic derivative of vancomycin used for select infections caused by Gram-positive bacteria including Staphylococcus aureus. Human clinical trials suggest that telavancin is potentially nephrotoxic, however there is no histopathologic description of acute kidney injury (AKI) in humans. An animal model has recently characterized the histologic changes associated with telavancin-induced AKI as proximal tubular injury with numerous phagolysosomes. We present a case of a 47-year-old man with methicillin-resistant Staphylococcus aureus bacteremia treated with telavancin, who developed AKI after 5 weeks of intravenous therapy. Acute tubular injury with lysosomal proliferation and acute interstitial nephritis were observed on kidney biopsy. To our knowledge, this is the first reported case of AKI due to telavancin that has documented kidney histopathology.
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