Two unusual pathological reactions to nitrofurantoin: case reports

Area of Science:

• Pulmonary Medicine
• Pathology
• Pharmacology

Background:

• Nitrofurantoin is a common antibiotic used for urinary tract infections.
• Idiosyncratic pulmonary reactions are known adverse effects of nitrofurantoin therapy.
• Eosinophilic pneumonia is the most frequently reported nitrofurantoin-induced lung injury.

Observation:

• This report describes two patients who developed uncommon lung reactions to nitrofurantoin.
• One patient presented with pathological findings similar to hypersensitivity pneumonitis.
• The second patient's lung biopsy mimicked giant cell interstitial pneumonia.

Findings:

• These cases highlight the diverse spectrum of nitrofurantoin-induced lung disease.
• Pathological examination revealed distinct patterns beyond the typical eosinophilic pneumonia.
• The findings underscore the importance of considering nitrofurantoin in the differential diagnosis of interstitial lung diseases.

Implications:

• Clinicians should be aware of these rare nitrofurantoin pulmonary reactions.
• Accurate pathological diagnosis is crucial for appropriate patient management.
• Further research may elucidate the mechanisms behind these idiosyncratic reactions.