Nitrofurantoin-induced pulmonary toxicity: A case report and review of the literature

Journal of Infection and Public Health
Wissam K Kabbara, Melissa C Kordahi

Abstract

This paper describes a case of lung injury attributed to the use of Nitrofurantoin and a review of the relevant literature. An 88-year-old woman was admitted to the floor for the evaluation of recent symptoms of dyspnea, fatigue and productive cough. She was initiated on nitrofurantoin 300 mg per day for the treatment of a urinary tract infection 3 days earlier. Upon examination, chest auscultation revealed bilateral inspiratory crackles. Chest radiograph showed bilateral airspace and interstitial infiltrates. Laboratory studies revealed an elevated white blood cell count of 13,500/μL (reference range = 5200-12,400/μL) and blood eosinophilia (10%, reference range: 0-7%). Using clinical judgment and the algorithm of Naranjo, it was determined that nitrofurantoin use was the probable cause of the patient's lung injury. Symptomatic improvement was observed shortly after the drug was discontinued. A review of information from several European and North American pharmacovigilance databases (through June 2014) identified several reports of suspected nitrofurantoin-induced toxicity, including reports of acute toxicity reactions, which were related in many ways to the case we are reporting here.

References

Jan 1, 1989·The Journal of Emergency Medicine·C R Chudnofsky, E J Otten
Jul 3, 2013·International Journal of Surgical Pathology·Kenneth K SakataHenry D Tazelaar

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Citations

Sep 15, 2016·Respiratory Medicine Case Reports·Jared W Davis, Lynn S Jones
Oct 11, 2016·Radiologic Clinics of North America·Melissa PriceCarol C Wu
Oct 26, 2016·Drug Safety - Case Reports·Kerry Anne Rambaran, Charles F Seifert
Jan 26, 2018·Medicine·Carmi BartalLeonid Barski
Apr 26, 2020·Diagnostics·Giulio DistefanoAntonio Basile
Sep 22, 2020·Curēus·Caitlin Batzlaff, Matt Koroscil
Nov 28, 2020·BMC Pulmonary Medicine·Lise Fischer Mikkelsen, Sune Rubak
Oct 23, 2020·Clinical Case Reports·Rehan KarmaliKaitlyn Simpson
Apr 16, 2021·BMJ Case Reports·Eliana MilazzoVamsi Kiran Korrapati

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