A CASE REPORT – NITROFURANTOIN TOXICITY MIMICKING PNEUMONIA

Dr Sonali Someek Basu, Dr Pranav Kumar

Abstract


Introduction : This Case report describes lung injury due to Nitrofurantoin use which presents as
Interstitial Lung Disease. A 70 yrs old presented with dyspnoea ,fatigue and cough. Previously he was
given nitrofurantoin for Urinary tract infection a couple of weeks ago. Chest X-ray has shown patchy and conuent air space
shadowing in both mid and both lower zones likely due to bilateral bronchopneumonia. There are no pleural effusions. There is
no pneumothorax.
Knowledge of adverse effect is essential for the early recognition and withdrawal of the drug. nitrofurantoin-induced lung
disease has a benign course and respond fully despite radiographic evidence of established lung brosis.Symptomatic
improvement was observed following steroid course soon after stopping Nitrofurantoin. A review information obtained from
North American and European pharmacological database identied reports on Nitrofurantoin toxicity. We are reporting a case
here demonstrating acute toxicity of Nitrofurantoin approximately 7-9 days after a short course of Nitrofurantoin.


Keywords


Nitrofurantoin toxicity, hypersensitivity reaction, pulmonary toxicity

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References


2018 TGL. eTG complete Therapeutic Guideline Australia. 2018th ed. 2018 TGL, editor. Victoria 3003, Australia : Therapeutic Guideline Australia ; 2018.

Mendez JL, Nadrous HF, Hartman TE, Ryu JH. Chronic Nitrofurantoin-Induced Lung Disease. Mayo Clinic Proceedings. 2005 October; 80(10).

Holmberg L, Boman. Pulmonary reactions to nitrofurantoin. European Journal of Respiratory Disease. 1981 June; 63(3).

Camus P, Fanton A, Bonniaud P, Camus C, Foucher P. Interstitial Lung Disease Induced by Drugs and Radiation. Respiration. 2004; 71(4).

Gupta K, Hooton TM, Naber KG, Wullt , Colgan R, Loren G. M, et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2011 March; 52(5).

Israel HL, Paul D. Recurrent Pulmonary Infiltration and Pleural Effusion Due to Nitrofurantoin Sensitivity. N Engl J Med. 1962 May; 266(1024-1026).

Sovijärvi A, Lemola M, Stenius B, Idänpään-Heikkilä J. Nitrofurantoin-induced acute, subacute and chronic pulmonary reactions. Scand J Respir Dis. 1977; 58(1-41-50).

Jick SS, Jick , Walker AM, Hunter JR. Hospitalizations for Pulmonary Reactions following Nitrofurantoin Use. Chest. 1989 September; 96(3).

Cameron R, Kolbe , Wilsher ML, Lambie. Bronchiolitis obliterans organising pneumonia associated with the use of nitrofurantoin. Thorax (BMJ). 2000 March; 55(3).

Martins RR, Marchiori , Viana SL, LSPGJ, VLC, LMV. Chronic eosinophilic pneumonia secondary to long-term use of nitrofurantoin: high-resolution computed tomography findings. Jornal Brasileiro de Pneumologia. 2008 March; 34(3).

Williams E, Triller D. Recurrent acute nitrofurantoin-induced pulmonary toxicity. Pharmacotherapy. 2006 May; 26(5).

Mendez JL, Nadrous HF, Hartman TE, Ryu JH. Chronic Nitrofurantoin-Induced Lung Disease. Mayo Clinic Proceedings. 2005 October; 80(10).

Taskinen E, Tukiainen P, Sovijärvi ARA. NITROFURANTOIN-INDUCED ALTERATIONS IN PULMONARY TISSUE. Acta Pathologica Microbiologica Scandinavica Section A Pathology. 1977 July; 85A(5).

Sakata KK, Larsen BT, Boland JM, Palen B, Muhm JR, Helmers RA, et al. Nitrofurantoin-Induced Granulomatous Interstitial Pneumonia. International Journal of Surgical Pathology. 2013 June; 22(4).

Averbuch SD, Yungbluth P. Archives of Internal Medicine. Archives of Internal Medicine (JAMA). 1980 February; 140(2).

Australia M. Macrodantin. 2018th ed. Australia M, editor. Australia : MIMS Australia ; 2018.

Handbook AM. Nitrofurantoin. 2018th ed. Handbook AM, editor. Australia : Australian Medical Handbook ; 2018.

MWI. Nitrofurantoin: potential direct and indirect mechanisms of lung injury. Chest. 1983 May; 83(5).

DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. eChapter 15Drug-Induced Pulmonary Diseases. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, editors. Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill; 2014.

2018 MO. Macrodantin. 2018th ed. 2018 MO, editor. Austrlia : MIMS Online 2018 ; 2018.

Boyd MR, Catignani GL, Sasame HA, Mitchell JR, Stiko AW. Acute Pulmonary Injury in Rats by Nitrofurantoin and Modification by Vitamin E, Dietary Fat, and Oxygen. ATS Journal -American Review of Respiratory Disease. 1979 July; 120(1).

Kabbara WK, Kordahi MC. Nitrofurantoin-induced pulmonary toxicity: A case report and review of the literature. Journal of Infection and public Health. 2015 July–August; 8(4).

Chudnofsky CR, Otten EJ. Acute pulmonary toxicity to nitrofurantoin. The Journal of Emergency Medicine. 1989 January–February; 7(1).

SA, VdWJ, KN, SN, KH. Nitrofurantoin-induced immune-mediated lung and liver disease. American Journal of Medical Science. 1999 May; 317(5).

HL, BG. Pulmonary reactions to nitrofurantoin. 447 cases reported to the Swedish Adverse Drug Reaction Committee 1966-1976. European Journal of Respiratory Disease. 1981 Jun; 62(3).

Brutine , Martin II. Chronic Nitrofurantoin Reaction Associated with T-Lymphocyte Alveolitis. Chest. 1986 January; 89(1).

Camus P , Fanton A , Bonniaud P , Camus C , Foucher P. Interstitial Lung Disease Induced by Drugs and Radiation. Respiration. 2004 July – August; 71(4).

VM, FMA, MJ, GRJ, IC, HJ. Rapid resolution of nitrofurantoin-induced interstitial lung disease. Archivos de Bronconeumologia. 2009 Jul; 45(7).

RB. Nitrofurantoin-induced interstitial pulmonary fibrosis. Presentation and outcome. THE Medical Journal of Australia. 1983 Jan; 1(2).


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