Age: 68.0
Sex: F
Vaccine: FLUX
Symptoms: Oliguria, Pyrexia, Thirst decreased, Ultrasound abdomen, Urinary retention
Clinical narrative: I am a 68 year old woman with diabetes mellitus Type 2, high blood pressure and high cholesterol. I take: metformin HCL 1000 mg BID; januvia 100 mg; QD amitriptyline 10 mg; QD fenofibrate 160 mg; QD lisinopril 20 mg, BID; omeprazole 20mg; QD toprol Xl, 25 mg. QD On September 29, 2021, I was prescribed clindamycin 300 mg every 6 hours for an abscessed tooth. On the 30th September we flew to (redacted). During the flight, I began to experience excessive thirst and dry mouth, as well as high blood sugar. Also, I noticed that my vision changed. Where I had needed reading glasses to read a book, I could read without glasses. I later discovered that where my distance vision had been in focus, it was suddenly blurry. That night, I discovered that I had no appetite and no stamina. I was exhausted more than usual. I could not walk very far without having to rest. I also discovered that I had to urinate every 2 hours. The abscessed tooth did not get better. It got worse. My entire right cheek swelled, and there was pain across my cheekbone. The pain got worse daily, as well as the swelling. I was taking Tylenol very four hours for the pain and discomfort. I finished the course of treatment on October 6. The swelling began to go down by the 8th, and the pain began to subside. Also, the thirst began to abate, the dry mouth ended, and I did not have to urinate as frequently. I still had no appetite, and my belly felt full. I was noticing changes in my bowels. I was having smaller, more frequent bowel movements. I was also going to sleep earlier, and taking naps during the day. As we were on vacation, I could not consult my doctor. I monitored my symptoms daily. We arrived home on October 16. I had no more bowel movements. I called my dentist on the 18th and reported my reaction to the clindamycin and requested a different antibiotic. She prescribed Amoxicillin 500 mg every 8 hours. On the 19th I received my annual flu shot, and on the 20th I developed a low grade fever and my joints ached. I was more uncomfortable than I had been. The next day, I stayed in bed most of the day, feeling sick. On the 22nd, I got up at 4 a.m. to urinate, and discovered that I could only pass about a teaspoonful. I was dizzy after being upright for a few minutes. At 8 a.m., I once again tried to urinate, and still only passed a teaspoonful. I was dizzy again. It was decided that I needed to visit the ER. At the ER, the doctor ordered bloodwork and an abdominal ultrasound. I was asked to provide a urine sample, but once again I could produce only a teaspoonful of urine. Once he had the test results, he ordered an IV at a fast drip, with the goal to rehydrate me and see if that would help. I had received nothing to eat or drink for 8 hours, and was neither thirsty or hungry. After a second bag of IV fluids, he decided to admit me so that I could receive more IV fluids. After I was admitted, the doctor ordered a bladder scan. Unfortunately, they could not find the bladder. The doctor next ordered a foley catheter. Once that was inserted, urine filled the bag. I was given magnesium citrate for the constipation. As the symptoms subsided, I began to feel better. I continued to receive IV fluids. I was released from the hospital on October 23 with a diagnosis of Acute Kidney Injury. I was advised to discontinue the metformin and lisinopril, and to not finish the amoxicillin. I was also told to call my Primary Care Provider and report my hospital stay. My doctor may have to find other medications to prescribe. I am assuming that the AKI was caused by clindamycin. I do not understand why it happened, but I am assuming it was either because I am Type 2, or it was an interaction with the metformin. I just wanted to make you aware of this experience. Hopefully you can do further research and discover why I had such a reaction to the medication. If you do wish to research my reaction and need