Acute pulmonary reaction to nitrofurantoin

Pinerua, R. F.; Hartnett, B. J. S.

doi:10.1136/thx.29.5.599

Cited by 7 publications

(3 citation statements)

References 32 publications

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“…The literature contains reports of pulmonary toxicity in patients receiving long-term therapy [3][4][5] as well as acute cases. 3,4,[6][7][8][9][10][11] In addition, the nitrofurantoin package insert warns, in bold type, "Chronic, subacute, or acute pulmonary hypersensitivity reactions may occur with the use of nitrofurantoin." 12 Our patient's case involved both rechallenge with nitrofurantoin and complete clinical data, which is not common in the existing literature.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Acute Nitrofurantoin-Induced Pulmonary Toxicity

Williams

Triller

2006

Pharmacotherapy

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Nitrofurantoin may be used for prophylaxis of recurrent urinary tract infections in women; however, this agent has been associated with acute, subacute, and chronic pulmonary adverse reactions. The acute reaction occurs in about 1/5,000 women after their first exposure to the drug. We report the occurrence of two successive, highly probable (by Naranjo score) nitrofurantoin-induced acute pulmonary reactions in the same patient. On day 4 of prophylaxis with nitrofurantoin 100 mg/day (to prevent urinary tract infections), the patient developed intense substernal pain and pressure. On day 8, she experienced intense substernal burning. She went to the emergency department, where she vomited and was hypotensive and febrile. Her chest radiograph showed bilateral infiltrates. The patient was diagnosed with pneumonia and was prescribed levofloxacin; she stopped taking the nitrofurantoin. Her symptoms subsided over the next 3 days. Ten days later, the patient restarted the nitrofurantoin, and she returned to the emergency department after again experiencing sudden intense substernal burning, nausea, vomiting, shivering, and weakness. Nitrofurantoin was discontinued; her symptoms resolved quickly, and prophylaxis with trimethoprim-sulfamethoxazole was begun. After 1 year, the patient had experienced no further pulmonary symptoms or urinary tract infections. Drug toxicity must be considered in patients who develop pulmonary symptoms while taking nitrofurantoin. Symptoms are often misdiagnosed as other ailments, potentially subjecting patients to unnecessary treatments and delaying discontinuation of nitrofurantoin. Patients should be advised to contact a physician if breathing difficulties or unusual symptoms develop while taking nitrofurantoin, as this could result in earlier recognition of this drug reaction.

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Section: Discussionmentioning

confidence: 99%

Recurrent Acute Nitrofurantoin-Induced Pulmonary Toxicity

Williams

Triller

2006

Pharmacotherapy

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“…One case of death from acute nitrofurantoin lung injury has been reported. 24 Pulmonary function pattern is usually restrictive in type, 32 obstructive type being extremely rare. However, in those patients who present with acute bronchospasm, flow limitation can be demonstrated.…”

Section: Pulmonary Reaction To Nitrofurantoinmentioning

confidence: 99%

Pulmonary Reaction to Nitrofurantoin

Prakash¹

1980

Semin Respir Crit Care Med

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“…Nitrofurantoin, commonly used in the treatment of urinary tract infections, is occasionally associated with acute and chronic pulmonary reactions (Demeter, Ahmad & Tomashefski 1979). The acute reaction is characteristically an eosinophilic pneumonia, whereas the chronic reaction is an interstitial fibrosis (Israel & Diamond 1962, Pinerua & Hartnett 1974, Sovijarvi et al 1977. This report documents two patients who had unusual pathological reactions, one appearing as a hypersensitivity pneumonitis, while the other resembled a giant cell interstitial pneumonia.…”

Section: Introductionmentioning

confidence: 99%