Case Presentation: A 92‐year‐old woman with a medical history of recurrent urinary tract infections (UTIs) presented with progressive dyspnea, a dry cough, and low‐grade fevers for 6 weeks. [shmabstracts.com]

Case presentation Here, we present a case of a 60-year-old established patient of ours who was initially seen on January 12, 2013, for symptoms related to a paraesophageal hernia. [ncbi.nlm.nih.gov]

Nitrofurantoin pulmonary toxicity can present as acute, subacute, or chronic respiratory disease. Common manifestations are dry cough, chest pain, dyspnea, and hypoxemia. Skin rash, arthralgia, and abnormal transaminases are occasionally present. [eurekaselect.com]

Patient B, an 81-year old women presented at the emergency department with symptoms of dyspnoea, fever, chest pain on inspiration and painful urination. [ntvg.nl]

Case presentation A 72 year old retired woman presented to her General Practitioner with breathlessness, upper abdominal discomfort and nausea. [link.springer.com]

• Recurrent Urinary Tract Infection

  Abstract: Nitrofurantoin is an antimicrobial agent that is commonly used for the treatment of recurrent urinary tract infection. Nitrofurantoin pulmonary toxicity can present as acute, subacute, or chronic respiratory disease. [eurekaselect.com]

  Antibiotics for preventing recurrent urinary tract infection in non-pregnant women. [bjmp.org]

  Nitrofurantoin lung toxicity was diagnosed among ten patients receiving 50 mg/day to prevent recurrent urinary tract infection. In six patients a symptomatic period of 3-36 months preceded the diagnosis. [ingentaconnect.com]

  Her recurrent urinary tract infections were controlled on Cefradine. Discussion Nitrofurantoin is an antibiotic commonly prescribed for urinary tract infections. [academic.oup.com]

  Nitrofurantoin is a broad-spectrum antibiotic used for clinical urinary tract infections, but may also be used in a prophylactic setting for patients with recurrent urinary tract infections. [ncbi.nlm.nih.gov]

• Inflammation

  ADL Marshall 1, HK Bayes 2, OJ Dempsey 3 1 Department of Respiratory Medicine, Glasgow Royal Infirmary, Glasgow, UK 2 Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK 3 Chest Clinic C, Aberdeen Royal Infirmary, Aberdeen [thorax.bmj.com]

  Radionuclide Scanning Nitrofurantoin-induced pulmonary toxicity results in inflammation in lung parenchyma. Gallium-67 citrate lung scintigraphy is highly sensitive test for the detection of pulmonary inflammation. [ispub.com]

  In the urinary bladder a large diverticulum of the posterior wall was observed with acute and chronic inflammation. [ncbi.nlm.nih.gov]

  Histology reveals interstitial inflammation superimposed on the dominant background of alveolar and ductal fibrosis. [emedicine.medscape.com]

• Malaise

  […] cerebellar dysfunction [ Ref ] Ocular Uncommon (0.1% to 1%): Amblyopia Rare (less than 0.1%): Optic neuritis, retinopathy (due to intraretinal crystals) Frequency not reported : Nystagmus, diplopia [ Ref ] Other Uncommon (0.1% to 1%): Fever, chills, malaise [drugs.com]

  Patients initially present with an acute episode of vague malaise, sneezing, nasal obstruction, rhinorrhea and, often, a productive cough. [emedicine.medscape.com]

• Respiratory Distress

  Drug-induced lung disease can result from a number of agents and can have a myriad of presentations, ranging from adult respiratory distress syndrome type picture to established pulmonary fibrosis. [radiopaedia.org]

  distress syndrome associated with nitrofurantoin use is described. [karger.com]

  FEB 2008; 29(2): 149-151 [Pubmed] 2 Nitrofurantoin-induced acute respiratory distress syndrome during pregnancy: A case report Sherif S. [jpgmonline.com]

  Symptoms usually resolve after discontinuation of the drug, but failure to resolve within 72 hours should alert the clinician to consider alternative diagnoses such as heart failure, infection and acute respiratory distress syndrome. [nature.com]

  Another symptom of ACEI therapy is angioneurotic edema (0.68% of patients). [55] It manifests as swelling of the tongue, lips, and mucous membranes within hours or weeks after initiating treatment and can rapidly evolve into respiratory distress. [emedicine.medscape.com]

• Pulmonary Disorder

  Several drugs cause pulmonary vasculitis, including nitrofurantoin, sulfonamides, penicillins, phenytoin, and propylthiouracil. This disorder is likely a form of hypersensitivity pneumonitis. [emedicine.medscape.com]

• Respiratory Insufficiency

  Unfortunately, she died as a result of progressive respiratory insufficiency. At autopsy bilateral patchy, sharply circumscribed fibrotic areas in the upper and lower lobes of the lungs were seen with honeycombing. [ncbi.nlm.nih.gov]

• Suggestibility

  Molecular evidence suggests that the presence of CK20 and CK7 is strongly associated with advanced malignancy and TTF-1 is found in type II pneumocytes and Clara cells, suggesting a better survival rate [3-4]. [ncbi.nlm.nih.gov]

  PHARMAC data suggests up to 5% of patients on Nitrofurantoin take it for longer than this.” [wellsaid.co.nz]

  Discussion We review the drug reactions associated with Nitrofurantoin and suggest an alternative treatment strategy for recurrent urinary sepsis. [link.springer.com]

Although workup did not reveal the typical presentation of a malignancy or a lung mass, nitrofurantoin was held as a precautionary measure especially since the patient has been using it chronically. [ncbi.nlm.nih.gov]

The case studies are not intended as a guide to treatment injury cover. Send your feedback to: [email protected] How ACC can help your patients following treatment injury Many patients may not require assistance following their treatment injury. [wellsaid.co.nz]

Abstract: Nitrofurantoin is an antimicrobial agent that is commonly used for the treatment of recurrent urinary tract infection. Nitrofurantoin pulmonary toxicity can present as acute, subacute, or chronic respiratory disease. [eurekaselect.com]

Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances. [books.google.com]

Discussion Nitrofurantoin is used for the prophylaxis and treatment of uncomplicated urinary tract infection. [link.springer.com]

Abstract Nitrofurantoin is an antibiotic commonly used for prophylaxis and treatment of urinary tract infections. Pulmonary and hepatic toxicity are rare side effects of this agent. [ncbi.nlm.nih.gov]

The prognosis is excellent if the condition is recognized early and nitrofurantoin exposure is discontinuated. [ntvg.nl]

The prognosis is good if the condition is recognized early, and nitrofurantoin exposure is stopped; however, rare fatalities have been reported. [shmabstracts.com]

Drug-induced autoimmune hepatitis: clinical characteristics and prognosis. Hepatology. 2010;51:2040–8. PubMed CrossRef Google Scholar 5. Triantafyllou K, Vlachogiannakos J, Ladas SD. [link.springer.com]

Nodule or Mass ) May appear as nodular infiltrates Acute Lung Injury-ARDS (see Acute Lung Injury-ARDS ) Other Adverse Effects Risk of Hemolysis in Patient with G6PD Deficiency (see Glucose-6-Phosphate Dehydrogenase Deficiency and Hemolytic Anemia ) Prognosis [mdnxs.com]

The prognosis is good. Most patients improve after discontinuation of the gold therapy. Penicillamine Penicillamine is an anti-inflammatory agent mostly used in the treatment of rheumatoid arthritis. [emedicine.medscape.com]

Bronchoalveolar lavage (BAL) and a transbronchial lung biopsy were negative for infectious and neoplastic etiologies. An echocardiogram showed normal ventricular and valvular functions. [shmabstracts.com]

[…] despite peripheral eosinophilia) Chronic Nitrofurantoin Toxicity : mimics idiopathic pulmonary fibrosis Adverse Effects Pulmonary Adverse Effects Acute Nitrofurantoin Toxicity (see Drug-Induced Pulmonary Eosinophilia, Pneumonia, Interstitial Lung Disease-Etiology [mdnxs.com]

Pathology Etiology Chemotherapy agents These can give several patterns of disease which include 1,5 : interstitial fibrosis : typically NSIP 5 pattern hypersensitivity pneumonitis pattern adult respiratory distress syndrome / diffuse alveolar damage pattern [radiopaedia.org]

Here, we present the clinical history and autopsy findings of a 51-year-old woman with a history of lung fibrosis of unknown etiology. [ncbi.nlm.nih.gov]

Viral infection (most commonly herpes simplex virus) is the likely etiology. Most patients recover, even without treatment, although about one in five is left with permanent facial disfigurement or pain. [sanfordguide.com]

Epidemiology One of the most common drug-induced pulmonary diseases Toxicity occurs in Physiology Acute Nitrofurantoin Toxicity : unclear mechanism (studies have shown prolonged lymhocyte transformation factor and migration inhibition factor production [mdnxs.com]

Selenium and lung cancer: a quantitative analysis of heterogeneity in the current epidemiological literature. Cancer Epidemiol Biomarkers Prev. 2004;13(5):771-778. (PubMed) 29. Yoshizawa K, Willett WC, Morris SJ, et al. [lpi.oregonstate.edu]

Q: For several years I have been taking nitrofurantoin 100 mg to prevent recurring bladder and urinary tract infections (UTIs). [aarp.org]

Abstract 5-Nitrofuran derivatives change the inner mitochondrial membrane permeability as indicated by the transmembrane potential, the rate of spontaneous K+ efflux and the basal respiratory rate: (a) at low concentrations nitrofurantoin prevents the [unboundmedicine.com]

Nitrofurantoin lung toxicity was diagnosed among ten patients receiving 50 mg/day to prevent recurrent urinary tract infection. In six patients a symptomatic period of 3-36 months preceded the diagnosis. [ingentaconnect.com]

SELECT: the Selenium and Vitamin E Cancer Prevention Trial: rationale and design. Prostate Cancer Prostatic Dis. 2000;3(3):145-151. (PubMed) 41. Clark LC, Marshall JR. [lpi.oregonstate.edu]