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Nitrofurantoin-Induced Granulomatous Interstitial Pneumonia
Kenneth K Sakata1, Brandon T Larsen2, Jennifer M Boland2
1Mayo Clinic, Scottsdale, AZ, USA.
International Journal of Surgical Pathology
|July 2, 2013
Summary
Nitrofurantoin can cause lung toxicity with rare granulomatous interstitial pneumonia. Early drug withdrawal, without steroids, led to complete recovery in a reported case.
Area of Science:
- Pulmonology
- Pharmacology
- Pathology
Background:
- Nitrofurantoin is frequently prescribed for urinary tract infections.
- Nitrofurantoin-induced lung toxicity is a known adverse effect.
- Diagnosis can be challenging due to rare histologic patterns.
Observation:
- A 69-year-old woman on prophylactic nitrofurantoin developed granulomatous interstitial pneumonia.
- The patient's condition improved solely upon discontinuation of nitrofurantoin.
- No other therapies, including steroids, were required for recovery.
Findings:
- This represents the fourth reported case of nitrofurantoin-associated granulomatous interstitial pneumonia.
- It is the first case demonstrating complete resolution with drug cessation alone.
- Idiosyncratic reactions to nitrofurantoin can manifest in diverse histologic patterns.
Implications:
- Recognizing granulomatous interstitial pneumonia as a nitrofurantoin toxicity manifestation is crucial.
- Early identification and prompt drug withdrawal are essential for preventing complications.
- This case highlights the potential for drug cessation alone to resolve rare nitrofurantoin lung toxicity.
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