A 65-Year-Old Woman Is Treated with Gentamicin for an Abdominal

A 65-year-old woman is treated with gentamicin for an abdominal infection complicated by multidrug-resistant organisms.  After a week of treatment, the patient's urine output decreases noticeably, and serum creatinine rises to 2.3 mg/dL.  She has no previous kidney disease, and baseline kidney function was normal prior to the initiation of therapy.  The patient has remained afebrile for 24 hours.  Blood pressure is 130/80 mm Hg and pulse is 80/min.  Examination shows moist mucous membranes.  There is no rash.  Results of urinalysis are as follows: Fractional excretion of sodium is >2%.  Histologic examination of the patient's kidneys would most likely show which of the following?

A) Focal tubular epithelial necrosis
B) Leukocytic infiltration of the glomerular capillaries
C) Leukocytic infiltration of the interstitium and tubules
D) Preservation of normal renal architecture
E) Replacement of glomeruli with collagen

Correct Answer:

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