To the Editor: We report a patient who presented with acute kidney injury after treatment with linezolid and Bactrim DS, 2 tablets twice a day, for a leg wound. The patient also was receiving furosemide for leg edema. Fractional excretion of sodium was 46%, and kidney ultrasound showed normal-sized kidneys with no hydronephrosis. Urinalysis showed pH of 5.5 and no protein, blood, leukocyte esterase, or nitrite. Polarized urine microscopy showed birefrin-gent pleomorphic crystalluria (Fig 1A). Some crystals had the characteristic "coffin lid" appearance suggesting struvite (triple phosphate) crystals. Others had notched edges suggestive of uric acid crystals. Still other crystals formed a rosette.
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