Auditory hallucinations associated with nitrofurantoin use: case report and review of the literature

Abstract

This case report can be used to remind clinicians and clinical pharmacists of keeping in mind the potential of NF associated with auditory hallucinations, which can be easily confused with more serious conditions.

Auditory and Visual Hallucinations Associated With Nitrofurantoin Use in an Inpatient Setting: A Case Report

“…Most often, patients may experience nausea, vomiting, and diarrhea; however, more severe side effects such as pulmonary fibrosis, hepatitis and hepatic necrosis, and aplastic anemia have been reported in rare cases [ 8 , 9 ]. Hallucinations are an extremely rare side effect of nitrofurantoin [ 11 ]. Other antibiotics have been implicated in causing hallucinations, including penicillin class, trimethoprim-sulfamethoxazole (TMP-SMX), and fluoroquinolones; however, nitrofurantoin as a cause is rarely mentioned in the current literature [ 10 ].…”

“…While we found reports of auditory hallucinations as a rare adverse effect of nitrofurantoin usage, no record of a combination of auditory and visual hallucinations was found. A case study from 2014 reported the presentation of auditory hallucinations in a patient with already-established Alzheimer’s disease [ 11 ]. Our patient had no history of any memory disorder and no issues related to mentation or cognitive function.…”

“…It has also been documented to cause pulmonary toxicity, liver injury, aplastic anemia, peripheral neuropathy, and hemolytic anemia as rarer adverse reactions [ 9 ]. While UTI-specific antibiotics have been implicated in altered mental status and hallucinations, there is scarce data in the literature with regard to nitrofurantoin-specific neuropsychiatric effects as an adverse effect of therapy [ 10 - 11 ].…”