Abstract

Nitrofurantoin is an antibacterial agent used in the management of urinary tract infections. It can rarely induce acute or chronic pulmonary toxicity and generate an interstitial pneumonitis which can turn into fibrosis, besides originating hepatic toxicity and other conditions.Chronic toxicity has a variable clinical expression, and its radiologic presentation forces to carry out a comprehensive differential diagnosis of interstitial lung conditions. The first measure would be the drug withdrawal, which usually ensures favourable evolution without supporting therapeutic measures.We present the case of a 69 year-old woman who consulted for chronic productive cough and lung sounds, with a history of recurrent cystitis treated with nitrofurantoin. The CT scan showed localized infiltrates together with interstitial lung disease with septal thickening and traction bronchiectasis. Hepatic toxicity data were also found.After drug withdrawal patient evolved favourably without the need for steroid treatment.

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