Pleuropneumonic Reactions to Nitrofurantoin

Bronchiolitis obliterans organising pneumonia associated with the use of nitrofurantoin

“…The “subacute” and “chronic” forms were more insidious, with increased eosinophil count, raised ESR, and vasculitis and interstitial inflammation on histological examination, consistent with a type III immune response 34 Increased immunoglobulin levels, hepatic transaminases and ANA titres (the so called “drug induced lupus syndrome”7 8) was associated with a degree of irreversible fibrosis. Some early reports of biopsy specimens from a patient with nitrofurantoin induced lung disease5 which predate the recognition of idiopathic BOOP as an independent entity are suggestive of a BOOP-like pattern.…”

Adult Respiratory Distress Syndrome Associated with Acute Nitrofurantoin Toxicity

“…Hailey el al. [4] compiled and reviewed approximately 200 cases of pulmonary reactions to nitrofuran toin over a 10-year period. A fatal reaction to nitrofurantoin was reported in 1975 [5], Despite the abundance of reports, the exact incidence of these reactions is unknown.…”

“…Multiple exposures with multiple reactions may occur before nitrofurantoin is recog nized as the causative agent. The recurrent episodes seem to occur at progressively shorter intervals following exposure [4], The severity of the reaction varies widely, and this may lead to difficulty in diagnosis in the milder cases, with erroneous initial diagnoses including influenza, pneumonia, pulmonary embolus, congestive heart fail ure, and myocardial infarction.…”

Nitrofurantoin-Associated Lung and Liver Toxicity Leading to Liver Transplantation in a Middle-Aged Patient

“…Chest radiography often indicates bilateral pleural effusion, with or without pulmonary infiltrates. 30 Similar to lung toxicity, acute liver toxicity from nitrofurantoin is more common than chronic liver injury.…”