Acquired Fanconi-Like Proximal Renal Tubulopathy Associated with Klebsiella Pneumoniae Infection.

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 LEARNING POINTS: This case describes the first documented case of acquired Fanconi-like proximal tubulopathy secondary to a systemic