Acute lung toxicity by nitrofurantoin.

Eliana Milazzo, Gabriela Orellana, Adriana Briceño-Bierwirth, Vamsi Kiran Korrapati

BMJ case reports 2021 Apr 14

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Nitrofurantoin is a synthetic derivative of imidazolinedione, used to treat uncomplicated urinary tract infections. It acts by inhibiting bacterial DNA, RNA and cell wall protein synthesis. It is used prophylactically as a urinary anti-infective agent against most gram-positive organism and for long-term suppression of infections. Nitrofurantoin-associated pulmonary injuries occur in 1% of patients, presenting with dyspnoea and dry cough, and it can mimic interstitial lung disease. We present a case of an 81-year-old woman with shortness of breath and cough 3 days after initiation of nitrofurantoin. CT of the chest revealed bilateral pleural effusion and extensive pulmonary interstitial prominence, suggesting pulmonary fibrosis. According to the Naranjo Adverse Drug Reaction Probability Scale score of 6, it was determined that nitrofurantoin was the probable cause, and immediate cessation of the medication showed a marked clinical improvement and resolution after 10 days. © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Eliana Milazzo, Gabriela Orellana, Adriana Briceño-Bierwirth, Vamsi Kiran Korrapati. Acute lung toxicity by nitrofurantoin. BMJ case reports. 2021 Apr 14;14(4)