Nitrofurantoin: cause of DRESS syndrome

Leão, Rodrigo Nazário; Barreto, Paulo; Leão, Ricardo; Ribeiro, José Vaz

doi:10.1136/bcr-2013-008991

Cited by 14 publications

(13 citation statements)

References 16 publications

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“…Recently, delayed evolution of ceftazidime-induced DRESS into an HLH-like picture was suggested [13] in the setting of exaggerated CD8+ T cell skewing.…”

Section: Statins-atorvastatinmentioning

confidence: 99%

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Eosinophilic Drug Allergy

Kuruvilla

Khan

2015

Clinic Rev Allerg Immunol

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While peripheral or tissue eosinophilia may certainly characterize drug eruptions, this feature is hardly pathognomonic for a medication-induced etiology. While delayed drug hypersensitivity reactions with prominent eosinophilic recruitment have been typically classified as type IVb reactions, their pathophysiology is now known to be more complex. Eosinophilic drug reactions have a diversity of presentations and may be benign and self-limited to severe and life-threatening. The extent of clinical involvement is also heterogeneous, ranging from isolated peripheral eosinophilia or single organ involvement (most often the skin and lung) to systemic disease affecting multiple organs, classically exemplified by drug-reaction with eosinophilia and systemic symptoms (DRESS). The spectrum of implicated medications in the causation of DRESS is ever expanding, and multiple factors including drug metabolites, specific HLA alleles, herpes viruses, and immune system activation have been implicated in pathogenesis. Due to this complex interplay of various factors, diagnostic workup in terms of skin and laboratory testing has not been validated. Similarly, the lack of controlled trials limits treatment options. This review also describes other localized as well as systemic manifestations of eosinophilic disease induced by various medication classes, including their individual pathophysiology, diagnosis, and management. Given the multitude of clinical patterns associated with eosinophilic drug allergy, the diagnosis can be challenging. Considerable deficits in our knowledge of these presentations remain, but the potential for severe reactions should be borne in mind in order to facilitate diagnosis and institute appropriate management.

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“…Recently, delayed evolution of ceftazidime-induced DRESS into an HLH-like picture was suggested [13] in the setting of exaggerated CD8+ T cell skewing.…”

Section: Statins-atorvastatinmentioning

confidence: 99%

“…Antibiotics-beta-lactams, sulfonamides, minocycline, ciprofloxacin [12], nitrofurantoin [13], azithromycin, linezolid [14] Antituberculosis medications-rifampin, amikacin [15,16] Proton pump inhibitors [17] Immunomodulators-cyclosporine, lenalidomide [18], leflunomide [19], dapsone, pentoxyphylline [20], sulfasalazine…”

Section: Risk Factorsmentioning

confidence: 99%

Eosinophilic Drug Allergy

Kuruvilla

Khan

2015

Clinic Rev Allerg Immunol

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“…48 Nitrofurantoin reaction with eosinophilia produces systemic symptom, may be lifethreatening condition, although very rarely observed. 49,50 Side Effects-Nitrofurantoin is normally well tolerated with common side effects include nausea and headache, Table 1. The uncommon side effects are aplastic anemia, peripheral neuropathy, liver toxicity, pulmonary toxicity, and Stevens -Johnson syndrome (SJS).…”

Section: Discussion Therapeutic Uses Of Nitrofurantoinmentioning

confidence: 99%

Role of Nitrofurantoin in the Management of Urinary Tract Infection - A Systematic Review

Alam¹,

Rana²,

Bhardwaj³

et al. 2019

jemds

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BACKGROUND Urinary tract infections are often caused by bacteria resistant to antibiotics which have evolved to be a major health issue in recent years. Often, urinary tract infections are very hard to treat and if not appropriately treated in time, may result in serious consequences, particularly, when it spreads to kidneys ultimately resulting in an increase in morbidity and mortality. Nitrofurantoin, a first line agent and has bactericidal action, frequently used to treat uncomplicated urinary tract infection. The literature was searched with published sources from Medline, PubMed and Embase search engines. Published articles were searched, of which 81 articles were eligible to be included for this systematic review. Nitrofurantoin is reduced by the action of bacterial flavoproteins to reactive intermediate compounds that non-specifically inactivate ribosomal proteins resulting in inhibition of protein synthesis. Various mechanisms seem to be responsible for the reduced capability of microorganism to acquire resistance in a faster manner. Nitrofurantoin exhibits high quality success against most bacteria anticipated in urinary tract infection. Nitrofurantoin has been recommended for prophylaxis in the treatment of reinfection in case of recurrent uncomplicated urinary tract infections in many western countries. Nitrofurantoin is one of the treatment options for urinary tract infection due to extended spectrum beta lactamase producing Escherichia coli. In pregnant women with urinary tract infection, nitrofurantoin can be appropriate treatment. Also, nitrofurantoin associated reactions have been reported in many studies. This review updates the clinical use of nitrofurantoin, including new facts about the role of nitrofurantoin in the therapy of community acquired urinary tract infection, adverse outcomes, complications, interactions and antibiotic resistance mechanism against different uropathogens.

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“…SIRS (systemic inflammatory response syndrome) and DRESS syndrome (drug rash, eosinophilia and systemic symptoms), a delayed type IV hypersensitivity reaction, have also been reported in connection with nitrofurantoin. 10,11 Progression to systemic lupus erythematosus…”

Section: Nitrofurantoin and Dilmentioning

confidence: 99%

Sub-acute cutaneous lupus erythematosus following nitrofurantoin: causative or coincidental?

Murie

Agarwal

2014

Scott Med J

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A 70-year-old woman presented with progressive skin lesions on the face, limbs and trunk in the absence of systemic illness. Three months earlier, she had been prescribed six months prophylactic nitrofurantoin for recurrent urinary tract infections, treated with nitrofurantoin and trimethoprim. Positive immunology and histological inflammatory changes in a skin biopsy were consistent with a diagnosis of sub-acute cutaneous lupus erythematosus. Following treatment with topical steroids, the skin lesions regressed, but alopecia followed and required hydroxychloroquine. One year later, there are no new skin lesions and no evidence of systemic lupus erythematosus. Nitrofurantoin is associated with many side effects and hypersensitivity reactions. Possible drug-induced lupus reactions due to nitrofurantoin include pneumonitis, blood disorders and hepatotoxicity. This is the only published case of isolated sub-acute cutaneous lupus following maintenance nitrofurantoin.

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Nitrofurantoin: cause of DRESS syndrome

Cited by 14 publications

References 16 publications

Eosinophilic Drug Allergy

Eosinophilic Drug Allergy

Role of Nitrofurantoin in the Management of Urinary Tract Infection - A Systematic Review

Sub-acute cutaneous lupus erythematosus following nitrofurantoin: causative or coincidental?

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