Chronic nitrofurantoin-induced lung disease.
OBJECTIVE
To reassess the clinical and radiological features of chronic nitrofurantoin-induced lung disease and eventual clinical outcome.


METHODS
We retrospectively reviewed the medical records of 18 patients with chronic nitrofurantoin-induced lung disease who were seen at the Mayo Clinic in Rochester, Minn, from January 1, 1997, to December 31, 2002.


RESULTS
The median age of the 18 patients was 72 years (range, 47-90 years) at the time of diagnosis; 17 (94%) were women. Onset of symptoms occurred after a median interval of 23 months (range, 10-144 months) following the initiation of nitrofurantoin therapy for the prevention of recurrent urinary tract infections. All patients presented with persistent dyspnea and cough associated with lung infiltrates detected on chest radiography. Ten computed tomograms were available for review and revealed bilateral areas of ground-glass opacities in all cases and showed subpleural Irregular linear opacities and patchy consolidation in some cases. Nitrofurantoin therapy was discontinued in all patients, and most improved subsequently; 9 patients received corticosteroid therapy.


CONCLUSIONS
Chronic nitrofurantoin-induced lung disease is seen predominantly in older women who present with respiratory symptoms after a year or more of nitrofurantoin therapy. Associated radiological features are relatively nonspecific but usually include bilateral areas of ground-glass opacities on computed tomography of the chest. Cessation of nitrofurantoin therapy leads to improvement and suffices in the management of some patients, although corticosteroid therapy may be helpful in those more severely affected.
Mendez
Jose L
JL
Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Nadrous
Hassan F
HF
Hartman
Thomas E
TE
Ryu
Jay H
JH
D000368:Aged; D000369:Aged, 80 and over; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009582:Nitrofurantoin / Q000009:adverse effects*; D011859:Radiography; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy
D000892:Anti-Infective Agents, Urinary; D009582:Nitrofurantoin