Allergic Pulmonary Complications During Treatment with Nitrofurantoin

Abstract

One case of allergic pulmonary reaction caused by nitrofurantoin is described, previously reported cases are reviewed. Onset of reaction is characterized by high fever, dyspnoea, severe cough, chest pain and acute distress, simulating disease such as pneumonia, pulmonary oedema, infarction, pulmonary emboli or influenza. X-ray often shows pulmonary infiltration and pleural effusion. There is leucocytosis and eosinophilia. Renewed exposition to the drug gives more dramatic symptoms at a shorter interval and smaller dose. Since chronic urinary infection in old people is often treated with nitrofurantoin and common acute cases with cardio-pulmonary disease belong to this age group, the differential diagnosis of allergic pulmonary reaction to nitrofurantoin should be borne in mind.