Abstract:
This paper describes a case of lung injury attributed to the use of Nitrofurantoin and a review of the relevant literature. An 88-year-old woman was admitted to the floor for the evaluation of recent symptoms of dyspnea, fatigue and productive cough. She was initiated on nitrofurantoin 300 mg per day for the treatment of a urinary tract infection 3 days earlier. Upon examination, chest auscultation revealed bilateral inspiratory crackles. Chest radiograph showed bilateral airspace and interstitial infiltrates. Laboratory studies revealed an elevated white blood cell count of 13,500/μL (reference range = 5200-12,400/μL) and blood eosinophilia (10%, reference range: 0-7%). Using clinical judgment and the algorithm of Naranjo, it was determined that nitrofurantoin use was the probable cause of the patient\'s lung injury. Symptomatic improvement was observed shortly after the drug was discontinued. A review of information from several European and North American pharmacovigilance databases (through June 2014) identified several reports of suspected nitrofurantoin-induced toxicity, including reports of acute toxicity reactions, which were related in many ways to the case we are reporting here.
摘要:
本文描述了一例归因于使用呋喃妥因的肺损伤,并回顾了相关文献。一名88岁的妇女被送入地板,以评估近期的呼吸困难症状,疲劳和生产性咳嗽。3天前,她开始每天服用300mg呋喃妥因治疗尿路感染。经检查,胸部听诊显示双侧吸气阵阵爆裂声。胸部X光片显示双侧空域和间质浸润。实验室研究显示白细胞计数升高13,500/μL(参考范围=5200-12,400/μL)和血嗜酸性粒细胞增多(10%,参考范围:0-7%)。使用临床判断和Naranjo的算法,已确定使用呋喃妥因是患者肺损伤的可能原因。停药后不久观察到症状改善。对来自几个欧洲和北美药物警戒数据库(截至2014年6月)的信息进行的审查发现了一些疑似呋喃妥因引起的毒性的报告。包括急性毒性反应的报告,这在很多方面都与我们在这里报道的案件有关。