Trois cas de néphropathie aiguë allergique aux pénicillines. Une autre cause d'insuffisance rénale au cours des endocardites infectieuses

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Clinical cases – We report three cases of acute renal failure during penicillin therapy for an infective endocarditis IE. The late occurrence, the decrease of creatinemia to normal after withdrawal of the drug, the presence of eosinophilia and, in one case, of eosinophiluria as well as the absence of any other cause of renal failure made the diagnosis of penicillin-induced allergic acute interstitial nephritis highly probable. This disease was first described in patients under methicillin treatment but may be observed with other beta-lactams. Only one third of patients present with the typical triad of renal failure with normal diuresis, fever, and rash. Acute interstitial nephritis should be considered as a potential cause of renal failure occurring during the treatment of infective endocarditis.