Consider Nitrofurantoin as a Cause of Lung Injury
| Autor: | Ana Margarida Araújo, Paulo Almeida, Beatriz Pinheiro, Eduarda Salomé Soares Seixas, Pedro Lopes Ferreira |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary toxicity
lcsh:Medicine nitrofurantoin Lung injury urologic and male genital diseases 030226 pharmacology & pharmacy organising pneumonia drug-induced lung toxicity 03 medical and health sciences 0302 clinical medicine Internal Medicine medicine Medical history pulmonary toxicity medicine.diagnostic_test business.industry lcsh:R Articles bacterial infections and mycoses female genital diseases and pregnancy complications Respiratory failure Nitrofurantoin 030220 oncology & carcinogenesis Anesthesia Prednisolone Crackles medicine.symptom Chest radiograph business medicine.drug |
| Zdroj: | European Journal of Case Reports in Internal Medicine (2019) European Journal of Case Reports in Internal Medicine |
| Popis: | Nitrofurantoin-induced diffuse lung toxicity is well documented in the literature but is often misdiagnosed. We describe an 82-year-old female medicated with nitrofurantoin for the previous 2 years who was admitted for dyspnoea, dry cough and fatigue for 4 months. She was febrile and tachypnoeic and she presented with bilateral basal crackles, hypoxaemic respiratory failure and slightly elevated C-reactive protein levels. A chest radiograph showed bilateral air-space consolidation and interstitial infiltrates and the high-resolution computed tomography scan was evocative of a perilobular pattern of organising pneumonia (OP). Due to the clinical–radiological context, she was diagnosed with a presumable nitrofurantoin-induced OP. She was started on prednisolone 60 mg daily with a progressive improvement. It is important that clinicians are aware of the spectrum of side effects associated with nitrofurantoin so as to monitor patients. LEARNING POINTS It is crucial to ensure that a thorough medical history with a systems review and a complete drug history are carried out. Chronic pulmonary toxicity due to nitrofurantoin is rare and it occurs primarily in older women who have been prescribed relatively small doses of nitrofurantoin for UTI prevention. The cessation of nitrofurantoin is the basis of the treatment and may be sufficient for clinical and radiological improvement. Keywords: Nitrofurantoin, pulmonary toxicity, drug-induced lung toxicity, organising pneumonia CASE DESCRIPTION An 82-year-old Caucasian female was admitted to the medical ward with worsening dyspnoea, shortness of breath, longstanding dry cough, intermittent fever and intense fatigue for approximately 4 months. She was hospitalised approximately 3 months previously due to a community-acquired pneumonia and treated with empiric antibiotherapy with a temporary improvement. She had hypertension controlled with losartan and urinary incontinence medicated with trospium chloride. No other medication was initially reported. She was a non-smoker with no occupational exposure or allergies. Upon examination, she was febrile (38.0oC), tachypnoeic and hypoxaemic with an SpO2 of 87% on room air. Chest auscultation revealed bilateral basal inspiratory crackles. Laboratory workup showed elevated C-reactive protein (3.0 mg/dl [ |
| Databáze: | OpenAIRE |
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