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Nitrofurantoin-induced lung- and hepatotoxicity
Anastasios Koulaouzidis1, Shivaram Bhat, John Moschos
1Department of Gastroenterology, Warrington Hospital, Warrington. akoulaouzidis@hotmail.com
Annals of Hepatology
|May 24, 2007
Summary
Nitrofurantoin, used for urinary tract infections, can cause rare lung pneumonitis and liver toxicity. Stopping the drug resolved the patient's symptoms and liver function abnormalities.
Area of Science:
- Gastroenterology
- Pulmonology
- Clinical Pharmacology
Background:
- Nitrofurantoin is a common antibiotic for urinary tract infections.
- Long-term prophylaxis with nitrofurantoin can be associated with adverse effects.
- Abnormal liver function tests warrant thorough investigation into potential drug-induced causes.
Observation:
- A patient on long-term nitrofurantoin prophylaxis presented with abnormal liver function tests.
- Computed tomography (CT) revealed lung pneumonitis and liver parenchymal changes.
- The patient had been taking nitrofurantoin for 16 months.
Findings:
- The patient was diagnosed with concurrent nitrofurantoin-induced pneumonitis and hepatotoxicity.
- Withdrawal of nitrofurantoin led to significant clinical and biochemical improvement.
- This dual organ toxicity from nitrofurantoin is an uncommon adverse event.
Implications:
- Highlights the importance of considering nitrofurantoin as a cause of both pneumonitis and hepatotoxicity.
- Emphasizes the need for vigilant monitoring of liver function and pulmonary symptoms in patients on long-term nitrofurantoin therapy.
- Suggests that early recognition and drug cessation can reverse these rare adverse reactions.
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