Crystal-induced nephrotoxicity associated with acyclovir use in paediatric patient

Drug-induced nephrotoxicity has evolved as one of the significant causes of renal failure in the contemporary setting accounting up to 20%. Acyclovir is an antiviral agent, which has the potential for precipitating transient crystal-induced nephrotoxicity, especially in elderly, euvolemic or renal patients when given as rapid intravenous bolus. The current case depicts evolution and management of transient nephropathy in a paediatric patient treated with acyclovir for viral encephalopathy. The case presents a contrasting scenario to the conventional milieu of risk factors and surmises the possibility of genetic factor predisposition.