The light at the end of the tunnel: an unusual case of acute kidney injury in a pediatric patient: Questions

Excerpt

A 19-year-old female patient presented to a local hospital emergency department, endorsing productive cough and shortness of breath, as well as intermittent vomiting and diarrhea. Initial vital signs showed a heart rate of 101/min and blood pressure of 121/69 mmHg. She weighed 89.3 kg on admission. Physical exam on presentation was significant for diminished breath sounds throughout, and end-expiratory wheezing. Laboratory tests showed a serum creatinine level of 4.9 mg/dL, blood urea nitrogen of 36 mg/dL, serum albumin of 1.9 g/dL, C-reactive protein of 76 mg/L, and erythrocyte sedimentation rate > 140 mm/h. Complete blood count showed a hemoglobin of 8.4 g/dL, white cell count of 15.5 K/cumm with 52% neutrophils and 37% lymphocytes, and platelet count 239 K/cumm. A chest X-ray revealed a right lower lobe opacity. A chest CT showed a multifocal right-sided pneumonia. Polymerase chain reaction testing of nasopharyngeal secretions was positive for Mycoplasma pneumoniae and rhinovirus/enterovirus. …