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Lobar nephronia or acute focal bacterial nephritis is an acute, non-suppurative, focal, renal infection.1 It usually presents with fevers and flank pain. In the general population it is well described in children. We report an adult co-infected with HIV and hepatitis C, who presented with meningism and bilateral lobar nephronia.
Case report
A 37 year old man was admitted with a 4 day history of headaches, fevers, and vomiting with a 2 week background of dysuria. On presentation with a seroconversion illness 3 years previously he received combination antiretroviral therapy (ARV) for 9 months. Four months before the current admission ARV was re-introduced for symptomatic HIV infection. The most recent CD4 count was 250 cells×106/l, and HIV viral …