{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:18:41Z","timestamp":1778159921158,"version":"3.51.4"},"reference-count":6,"publisher":"SMC Media","issue":"5","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>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\u00a0Klebsiella 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\u00a0K. pneumoniae\u00a0infection presenting with reversible Fanconi- like proximal tubulopathy highlighting the importance of exploring infectious causes in patients with unexplained proximal renal tubular dysfunction.<\/jats:p>","DOI":"10.12890\/2026_006469","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:30:47Z","timestamp":1776691847000},"source":"Crossref","is-referenced-by-count":0,"title":["Acquired Fanconi-like proximal renal tubulopathy associated with Klebsiella pneumoniae infection"],"prefix":"10.12890","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3976-8428","authenticated-orcid":false,"given":"Shilpa","family":"Suthanthararajan","sequence":"first","affiliation":[{"name":"Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1902-5043","authenticated-orcid":false,"given":"Margrat","family":"Das","sequence":"first","affiliation":[{"name":"Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thasneem","family":"Ara","sequence":"first","affiliation":[{"name":"Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3711-6400","authenticated-orcid":false,"given":"Vinoth","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujan","family":"Vishwanath","sequence":"first","affiliation":[{"name":"Department of General Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"10.12890\/2026_006469_ref1","unstructured":"Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki KL, Taal MW, editors. Brenner and Rector\u2019s The Kidney. 11th ed. Philadelphia (PA): Elsevier; 2019."},{"key":"10.12890\/2026_006469_ref2","doi-asserted-by":"crossref","unstructured":"Kinoshita-Katahashi N, Fukasawa H, Ishigaki S, Isobe S, Imokawa S, Fujigaki Y, et al. Acquired Fanconi syndrome in patients with Legionella pneumonia. BMC Nephrol 2013;14:171. doi: 10.1186\/1471-2369-14-171","DOI":"10.1186\/1471-2369-14-171"},{"key":"10.12890\/2026_006469_ref3","doi-asserted-by":"crossref","unstructured":"Koda R, Itoh R, Tsuchida M, Ohashi K, Iino N, Takada T, et al. Legionella Pneumonia Complicated with Acquired Fanconi Syndrome. Intern Med 2018;57:2975-2980. doi: 10.2169\/internalmedicine.0942-18","DOI":"10.2169\/internalmedicine.0942-18"},{"key":"10.12890\/2026_006469_ref4","doi-asserted-by":"crossref","unstructured":"Ryuge A, Ito Y, Yamakawa T, Tanaka H, Yasui H, Mashimo S, et al. Fanconi syndrome associated with hyponatremia in two patients with Legionella pneumonia. Intern Med 2016;55:3479\u20133484. doi: 10.2169\/internalmedicine.55.3479","DOI":"10.2169\/internalmedicine.55.7297"},{"key":"10.12890\/2026_006469_ref5","doi-asserted-by":"crossref","unstructured":"Soh JXJ, Goh RKH, Zheng S. Invasive pneumococcal disease associated with Fanconi-like syndrome. Eur J Case Rep Intern Med 2019;6:001230. doi: 10.12890\/2019_001230","DOI":"10.12890\/2019_001230"},{"key":"10.12890\/2026_006469_ref6","doi-asserted-by":"crossref","unstructured":"Weiner M, Coen M, Serratrice J, Mavrakanas TA, Leidi A. Acute kidney injury with partial Fanconi syndrome in a patient with leptospirosis: a case report. J Med Case Rep 2021;15:358. doi: 10.1186\/s13256-021-02978-0","DOI":"10.1186\/s13256-021-02978-0"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6469\/5478","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6469\/5479","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6469\/5479","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:58:56Z","timestamp":1778158736000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/6469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":6,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.12890\/2026_006469","relation":{"has-manifestation":[{"id-type":"other","id":"1-167-6469-g5478","asserted-by":"subject"},{"id-type":"other","id":"1-167-6469-g5479","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-167","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]}}}