Related Experiment Video
Updated: Jun 20, 2026
07:38
Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
Published on: May 6, 2018
Nitrofurantoin-induced systemic inflammatory response syndrome.
Christopher J Forster1, Brian M Cohee, Robert N Wood-Morris
1Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307, USA. christopher.forster@amedd.army.mil
The American Journal of the Medical Sciences
|September 4, 2009
Summary
Nitrofurantoin can cause a severe reaction called systemic inflammatory response syndrome, not just urinary tract infections. This adverse drug reaction mimics recurrent infections, highlighting a critical diagnostic challenge.
Area of Science:
- Pharmacology
- Infectious Diseases
- Critical Care Medicine
Background:
- Nitrofurantoin is a widely prescribed antibiotic for urinary tract infections (UTIs).
- Prophylaxis and treatment of UTIs are common indications for nitrofurantoin use.
- Adverse drug reactions (ADRs) associated with nitrofurantoin require ongoing surveillance.
Observation:
- A patient presented with symptoms initially suggestive of recurrent urinary tract infections.
- The clinical presentation was complex and mimicked a persistent or recurring infectious process.
- Systemic inflammatory response syndrome (SIRS) was suspected as a potential diagnosis.
Findings:
- This case represents the first documented instance of nitrofurantoin-induced systemic inflammatory response syndrome.
- Nitrofurantoin, a common UTI antibiotic, was identified as the causative agent for SIRS.
- The adverse drug reaction presented atypically, mimicking a recurrent infection.
Implications:
- Clinicians should consider nitrofurantoin-induced SIRS in patients presenting with severe symptoms despite appropriate UTI treatment.
- Early recognition of this ADR is crucial for timely drug withdrawal and management.
- This finding expands the known spectrum of nitrofurantoin's adverse effects, emphasizing the need for vigilant monitoring.
Related Concept Videos
01:27Acute Pyelonephritis I: Introduction
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
01:25Acute Inflammation III: Local and Systemic Effects
Acute inflammation produces a coordinated set of local and systemic changes that limit injury, eliminate pathogens, and initiate repair. These responses arise within minutes of infection, trauma, or chemical insult and are driven by vascular alterations and leukocyte-derived mediators. When the stimulus resolves, the reaction typically abates within days.Local EffectsAt the site of injury, arteriolar vasodilation increases blood flow, resulting in redness and warmth. Simultaneously, increased...
01:30Inflammatory Response I: Vascular and Cellular
The inflammatory response is the body's defense against infection, injury, or irritation from bacteria, trauma, toxins, or heat. Inflammation helps locate and destroy pathogens and remove damaged tissue elements to heal the body. During this initial phase, fluid, blood products, and nutrients migrate to the injured area, resulting in redness, heat, swelling, ache, and loss of function. Moreover, signs of systemic inflammation include fever, increased WBC count, malaise, anorexia, nausea,...
01:28Inflammatory Response
An inflammatory response is a localized, nonspecific immune reaction that occurs when a tissue is injured. It is characterized by redness, swelling, heat, and pain, which are commonly called the cardinal signs and symptoms of inflammation. Inflammation can sometimes result in a loss of function.
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
01:28Inhibitors of Bacterial DNA Synthesis
Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These antibiotics are selectively...
01:202° Amines to N-Nitrosamines: Reaction with NaNO2
Secondary amines react with nitrous acid to form N-nitrosamines, as depicted in Figure 1. Nitrous acid, a weak and unstable acid, is formed in situ from an aqueous solution of sodium nitrite and strong acids, such as hydrochloric acid or sulfuric acid, in cold conditions. In the presence of an acid, the nitrous acid gets protonated. The subsequent loss of water results in the formation of the electrophile known as nitrosonium ion.