TUMEFACTIVE MEGALOCYTIC INTERSTITIAL NEPHRITIS IN A PATIENT WITH ESCHERICHIA-COLI BACTEREMIA

Megalocytic interstitial nephritis is rare and primarily affects the c ortex in an otherwise normal kidney. We recently encountered a patient with Escherichia coli bacteremia and oliguric acute renal failure who died of gram-negative septicemia. At autopsy, this patient's kidneys displayed typical features of megalocytic interstitial nephritis. We w ere able to perform special stains suggesting that the histiocytic int erstitial cells originated from infiltrating macrophages. Our patient illustrates that macrophage proliferation can result in interstitial i nflammation sufficiently severe to cause anuric acute renal failure. ( C) 1995 by the National Kidney Foundation, Inc.