8th July 2024

A 55-year-old male presents with a 4 day history of lethargy and nausea

A 55-year-old male presents with a 4 day history of lethargy and nausea. He has been started on Erythromycin 2 days ago by his GP for a skin infection. He had a renal transplant 3 months ago and his last blood tests on clinic follow up 4 weeks ago showed normal renal function. On examination, blood pressure was 160/95 mmHg and temperature was 37.2 C. There was no tenderness over the graft. Investigations show: Hb 108 g/L (115-165), WBC 3.1×10⁹/L (4-11), Platelets 190×10⁹/L (150-400), Na 138 mmol/L (135-145), K 5.4 mmol/L (3.5-5), Urea 9.9mmol/L (2.5-7.5), Creatinine 170 μmol/L (60-110), CRP- 36 mg/L (<5). Urine Dipstick showed 1+ protein and was negative for blood.

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