Ventilation-perfusion lung imaging in nitrofurantoin-related pulmonary reaction.
A woman with a history of multiple drug allergies was admitted for cough and dyspnea. She had been taking nitrofurantoin for 10 days, was febrile, and had a rash on the trunk and extremities. A chest radiograph revealed right-sided pleural effusion and basal markings. Because of suspected nitrofurantoin-related pulmonary reaction, the medication was discontinued and the patient was started on an H2-blocker and intravenous corticosteroids. She improved clinically, and within 24 hours a radiograph revealed that her chest had largely cleared. Restricted distribution of radioxenon, seen initially on a ventilation lung scan, also reverted to near normal by the follow-up. The first perfusion lung scan showed multiple but nonspecific changes; this also came back to near normal. The nitrofurantoin-related pulmonary reaction should be considered in patients who present with pulmonary signs/symptoms while on the medication.
Lee
N K
NK
Department of Nuclear Medicine, University of Connecticut Health Center, Farmington 06030.
Slavin
J D
JD
Spencer
R P
RP
D004342:Drug Hypersensitivity / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009582:Nitrofurantoin / Q000009:adverse effects* / Q000627:therapeutic use; D010996:Pleural Effusion / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D013670:Sodium Pertechnetate Tc 99m; D014552:Urinary Tract Infections / Q000188:drug therapy; D014692:Ventilation-Perfusion Ratio / Q000502:physiology; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes; D009582:Nitrofurantoin; D013670:Sodium Pertechnetate Tc 99m