Fatal nitrofurantoin lung (original) (raw)
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Nitrofurantoin-induced lung- and hepatotoxicity
Annals of hepatology
We present the case of a patient referred to the gastroenterology service for investigation of abnormal liver function tests. She had been taking nitrofurantoin for 16 months as prophylaxis against urinary tract infections. CT scan showed evidence of lung pneumonitis and low attenuation in the liver parenchyma. Nitrofurantoin-induced pneumonitis and hepatotoxicity was diagnosed. The patient responded both clinically and biochemically to withdrawal of nitrofurantoin. This combination of adverse reaction to nitrofurantoin is rare.
Nitrofurantoin Toxicity: A Near Case of Mistaken Identity
A39. DRUG RELATED CASE REPORTS, 2019
Nitrofurantoin is one of the most utilized antibiotics to treat bladder and urinary tract infections (UTIs). Despite the clinical benefits, it requires vigilant monitoring, as it can cause damage to multiple organs, especially the lungs and the liver. This case is an example of clinical vigilance, which provided tremendous benefit for the patient.
Advances in respiratory medicine, 2017
Nitrofurantoin is one of the most common drugs implicated in drug-induced pulmonary toxicities, the manifestations of which range from dose-independent acute self-limiting reactions to chronic dose-dependent pathologies. The severity of these pulmonary adverse effects may range from trivial hypersensitivity reactions to extensive and irreversible lung fibrosis leading to respiratory failure and death. Symptomatic and supportive treatment in addition to discontinuation of the drug usually suffices for the management of mild reactions. Corticosteroids have been traditionally used to relieve the symptoms and hasten the resolution of pulmonary lesions in case of severe toxicities. However conclusive evidence in the form of controlled studies in favor of this routine use is lacking. We report a case of an elderly lady who presented to us in respiratory failure due to nitrofurantoin induced chronic lung disease. The patient's symptoms and blood gas abnormalities resolved spontaneously...
Pulmonary Fibrosis Due to Nitrofurantoin Therapy: A Case Report
Open Journal of Respiratory Diseases, 2017
We report the case of a patient with pulmonary fibrosis, developed as an adverse reaction to nitrofurantoin therapy received for totally 6 months for the prevention of recurrent urinary tract infections. Chest X-ray and CT scan revealed extensive elements of interstitial pulmonary fibrosis. After diagnosis, administration of nitrofurantoin was immediately stopped; and specific prolonged therapy with low-dose corticosteroids per os and inhaled steroids were administered. The patient responded successfully both clinically and biochemically and possible digestive system side effects were prevented through the administration of gastroprotection medication. For the prevention of urinary tract infection, the patient received well tolerated therapy with fosfomycin which was further continued as a prophylactic agent.
Long-term nitrofurantoin: analysis of complication awareness, monitoring and pulmonary injury cases
BJGP open, 2021
BACKGROUND Long-term nitrofurantoin (NF) treatment can result in pulmonary and hepatic injury. Current guidelines do not outline the type or frequency of monitoring required for detection of these injuries. AIMS To assess (1) awareness of NF complications among prescribers, (2) monitoring practice and (3) to describe the pulmonary sequelae of NF-related complications. METHODS (1) Electronic questionnaire to prescribers, interrogating prescribing/monitoring practices and awareness of complications; (2) Case-note review (June-July 2020) of NF monitoring among general practitioners (GPs) in our local clinical commissioning group; (3) Case review of patients diagnosed with nitrofurantoin-induced interstitial lung disease (NFILD) at our interstitial lung disease (ILD) centre (2014-2020). RESULTS 125 prescribers of long-term NF responded to the questionnaire (82% GPs; 12% urologists). Many were unaware of the potential for liver (42%) and lung (28%) complications. 41% and 53% never monito...
Cureus
Nitrofurantoin is a commonly used treatment for urinary tract infections with a risk for pulmonary toxicity. We report a case of a 48-year-old woman on a prophylactic regimen of nitrofurantoin who exhibited classic signs of bacterial sepsis including elevated procalcitonin (PCL) and C-reactive protein (CRP) levels two days post-nephrolithotripsy. The microbial analysis did not reveal an infectious cause for the initial symptoms and, subsequently, the patient developed a dry cough, fever, chills, and transient hypoxemia requiring supplemental oxygen. Pulmonary imaging revealed significant abnormal features inconsistent with the patient's symptoms which indicated an inflammatory/immune reaction to nitrofurantoin. Treatment discontinuation improved the patient's symptoms and reduced PCL and CRP levels to within normal limits. A high index of suspicion for nitrofurantoin-associated pulmonary toxicity is warranted for patients on a regimen of nitrofurantoin who exhibit severe pulmonary symptoms and elevated PCL and CRP levels with no corresponding infection.