We investigate the implications of the four-nucleon terms in the chiral eff
ective Lagrangian for the s-wave K-nucleon effective interaction. We nd tha
t such terms play a nontrivial role in the description of symmetric nuclear
matter. Our results for the kaon effective energy and in-medium K+- nucleo
n scattering are in agreement with the previous prediction obtained by in-m
edium scaling qualitatively.