Nitrofurantoin-Induced Pulmonary Reaction Involving Respiratory Symptoms: Case Report

Kanji, Zahra; Su, Victoria; Mainra, Raj

doi:10.4212/cjhp.v64i5.1072

Cited by 12 publications

(15 citation statements)

References 16 publications

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“…These include: (1) good hygiene practices to reduce gut uropathogen exposure and ascension; (2) frequent assisted bladder voiding to periodically eliminate bacteriuria and prevent bacteria adhesion; and, (3) long‐term daily nonantibiotic prophylactics such as urine acidifiers like ammonium chloride and urinary tract antiseptics like nitrofurantoin, methenamine hippurate, and methenamine mandelate to render bacterial colonization and multiplication unfavorable. Although these nonantibiotic prophylactics have demonstrated efficacy in preventing the recurrence of urinary tract infections in some studies including one in which a 5.4‐fold reduction during nitrofurantoin prophylaxis was reported in 219 women, adverse effects including nausea and acute pulmonary reactions and injuries have also been documented …”

Section: Current and Potential Therapiesmentioning

confidence: 99%

Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury

Granger

Jeffery

2016

Veterinary Internal Medicne

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Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C‐fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex‐mediated simultaneous detrusor and sphincter contractions or detrusor‐sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease‐associated changes can impact on the quality of life and life expectancy of spinal‐injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.

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Section: Current and Potential Therapiesmentioning

confidence: 99%

Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury

Granger

Jeffery

2016

Veterinary Internal Medicne

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“…However, the link between the rare but serious adverse effect between nitrofurantoin and interstitial lung disease is well-documented in the literature [5, 25–29] and should be taken into account when selecting a chronic prophylactic regimen. Studies have shown nitrofurantoin to be clinically efficacious to ciprofloxacin, third-generation cephalosporins, and amoxicillin for the treatment of UTIs [2, 7, 30].…”

Section: Discussionmentioning

confidence: 99%

Unrecognized Interstitial Lung Disease as a Result of Chronic Nitrofurantoin Use

Rambaran

Seifert

2016

Drug Saf - Case Rep

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Drug-induced interstitial lung disease is a rare condition attributed to several medications, including antimicrobial agents such as amphotericin B, anti-inflammatory agents such as methotrexate, biologic agents such as bevacizumab, and cardiovascular agents and chemotherapeutic agents. We describe the case of a 73-year-old female who developed interstitial lung disease following chronic use of nitrofurantoin for a urinary tract infection (UTI). The patient was taking nitrofurantoin 100 mg capsules twice daily for approximately 3 years. She presented to the hospital with complaints of a persistent dry cough that started 2 years previously. Her chest radiograph revealed bilateral reticular opacities and some atelectasis. Computed tomography of the chest demonstrated development of subpleural reticular opacities with minimal honeycombing. The patient had a severe restrictive defect on her pulmonary function tests, with a significant reduction in her carbon monoxide diffusion capacity. Multiple infectious disease and autoimmune tests were negative. Utilizing the algorithm of Naranjo (score of 9), it was determined that chronic use of nitrofurantoin was the definite cause of the patient’s interstitial lung disease. Nitrofurantoin was discontinued and she was treated with oxygen and started on an oral steroid, both of which were continued permanently once discharged. Upon discharge, the patient was maintained on 5 L of oxygen at rest and 10 L of oxygen when ambulating. Unfortunately, her lung disease ultimately resulted in her demise several months after her diagnosis. This case report illustrates the importance of rapid recognition of drug-induced lung injuries and discontinuation of the offending agent.

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“…Pulmonary reaction secondary to nitrofurantoin is a potentially serious, even fatal, adverse drug reaction [9]. Both acute and chronic forms of nitrofurantoininduced pulmonary injury have been reported.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Fibrosis Due to Nitrofurantoin Therapy: A Case Report

Grigorakos¹,

Poulakou²,

Lazarescu³

et al. 2017

OJRD

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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.

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Nitrofurantoin-Induced Pulmonary Reaction Involving Respiratory Symptoms: Case Report

Cited by 12 publications

References 16 publications

Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury

Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury

Unrecognized Interstitial Lung Disease as a Result of Chronic Nitrofurantoin Use

Pulmonary Fibrosis Due to Nitrofurantoin Therapy: A Case Report

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