Bronchiolitis obliterans organising pneumonia associated with the use of nitrofurantoin.
The spectrum of nitrofurantoin lung injury continues to widen. The case histories are presented of two patients who developed lung disease associated with the use of nitrofurantoin with histological features of bronchiolitis obliterans organising pneumonia (BOOP), a rare but recognised form of drug induced injury. The two middle aged women presented with respiratory symptoms after prolonged treatment with nitrofurantoin. Both had impaired lung function and abnormal computed tomographic scans, and their condition improved when nitrofurantoin was withdrawn and corticosteroid treatment commenced. The favourable outcome in these two patients contrasts with the fatal outcome of the two other reported cases of nitrofurantoin induced BOOP. We suggest that the previous classification of nitrofurantoin induced lung injury into "acute" and "chronic" injury is an oversimplification in view of the wide variety of pathological entities that have subsequently emerged.
Cameron
R J
RJ
Respiratory Services, Green Lane Hospital, Green Lane West, Auckland 3, New Zealand.
Kolbe
J
J
Wilsher
M L
ML
Lambie
N
N
D000328:Adult; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018549:Cryptogenic Organizing Pneumonia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008875:Middle Aged; D009582:Nitrofurantoin / Q000009:adverse effects*; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity
D000892:Anti-Infective Agents, Urinary; D000893:Anti-Inflammatory Agents; D009582:Nitrofurantoin; D011241:Prednisone