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Identification of Amoxicillin Crystals in Urine: a Case Report by Alessandra Fanelli, Stefano Rapi, Stefano Dugheri, Alessandro Bonari, Eva Milletti, Giovanni Cappelli, Nicola Mucci, Giulio Arcangeli

Background: The case concerns a 30-year-old woman in the 24th week of pregnancy presenting to the medical emergency room with fever and abdominal pain. Urine sediment microscopy revealed the presence of unknown needle-shaped crystals.
Methods: Crystals identification was performed by Fourier-Transform Infrared Spectroscopy coupled to Attenuated Total Reflectance (FTIR-ATR).
Results: Amoxicillin crystals were verified with semiquantitative results of 87.7%.
Conclusions: Drug-induced crystalluria is a frequent finding in urine examination and it may be asymptomatic. FTIR spectroscopy is a rapid and specific tool in identification of crystals and could be useful supporting renal disease diagnosis and monitoring drug therapy.

DOI: 10.7754/Clin.Lab.2019.190606