DOI: 10.12890/2026_006469

Acquired Fanconi-like proximal renal tubulopathy associated with Klebsiella pneumoniae infection

Authors

  • Shilpa Suthanthararajan Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India 0009-0004-3976-8428
  • Margrat Das Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India 0009-0001-1902-5043
  • Thasneem Ara Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India
  • Vinoth Kumar Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India 0009-0000-3711-6400
  • Sujan Vishwanath Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India

shilpa1995@gmail.com

Keywords

Fanconi syndrome, proximal renal tubulopathy, Klebsiella pneumoniae, dyselectrolytemia, renal glycosuria

Abstract

Acquired Fanconi syndrome is a rare proximal renal tubular disorder associated with glucosuria, aminoaciduria, phosphaturia, electrolyte disturbance and metabolic acidosis, usually caused by drugs, toxins, or plasma cell disorders. Although infectious causes are rare, this is a case report of a 68-year-old man with altered sensorium due to metabolic encephalopathy secondary to dyselectrolytemia. Evaluation revealed severe hyponatremia, hypokalemia, hypocalcaemia, hypophosphatemia and hypomagnesemia. Urine examination showed proteinuria, normoglycemic glycosuria, inappropriate urinary electrolyte losses and impaired urine concentrating ability. Arterial blood gas analysis showed a normal anion gap metabolic acidosis with a positive urine anion gap suggesting a renal cause for the acidosis. This clinical and laboratory picture is consistent with Fanconi-like proximal tubulopathy. Radiological imaging showed cavitary lung consolidation and bilateral pyelonephritis. Sputum cultures grew Klebsiella pneumoniae. After excluding the usual causes of acquired Fanconi syndrome, the proximal tubular dysfunction was attributed to systemic infection. Following treatment with appropriate antibiotics for the infection and electrolyte replacement, the patient completely recovered clinically and biochemically. This case documents a systemic K. pneumoniae infection presenting with reversible Fanconi- like proximal tubulopathy highlighting the importance of exploring infectious causes in patients with unexplained proximal renal tubular dysfunction.

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References

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Published

2026-04-20

Issue

Vol. 13 No. 5 (2026)

Categories

How to Cite

1.
Suthanthararajan S, Das M, Ara T, Kumar V, Vishwanath S. Acquired Fanconi-like proximal renal tubulopathy associated with Klebsiella pneumoniae infection. EJCRIM [Internet]. 2026 Apr. 20 [cited 2026 Nov. 3];13(5). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6469