Combined nitrofurantoin toxicity to liver and lung

H H Reinhart ¹, E Reinhart , P Korlipara

⁰Division of Infectious Diseases, Wayne State University, Detroit, Michigan.

Gastroenterology +

|

April 1, 1992

View abstract on PubMed

Summary

Long-term nitrofurantoin use can cause rare lung and liver damage. Discontinuing the antibiotic led to a full recovery, highlighting its potential toxicity in urinary tract infection treatment.

Area Of Science

Pharmacology
Pulmonology
Hepatology

Background

Nitrofurantoin is a common antibiotic for urinary tract infections (UTIs).
Pulmonary and hepatic toxicity are rare but serious side effects.
Long-term use necessitates monitoring for adverse effects.

Observation

A patient on long-term nitrofurantoin therapy developed simultaneous pulmonary fibrosis and chronic active hepatitis.
Pulmonary toxicity was indicated by chest radiograph infiltrates and reduced diffusion capacity.
Elevated liver enzymes and autoantibodies (anti-smooth muscle, antinuclear) suggested chronic hepatitis, confirmed by biopsy.

Findings

The patient experienced concurrent pulmonary and hepatic toxicity attributed to nitrofurantoin.
Discontinuation of nitrofurantoin resulted in complete resolution of symptoms.
Radiographic infiltrates resolved, and liver function normalized without corticosteroid intervention.

Implications

This case underscores the potential for severe, simultaneous pulmonary and hepatic toxicity with long-term nitrofurantoin use.
Early recognition and discontinuation of the drug are crucial for patient recovery.
Highlights the importance of vigilant monitoring for rare adverse drug reactions in clinical practice.

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