Medicine in images
Reversible pulmonary toxicity by nitrofurantoin
Toxicidad pulmonar reversible por nitrofurantoína
S.M. Santos Seoane
, R. Fernández-Madera-Martínez, M.L. Taboada-Martínez
Corresponding author
Servicio de Medicina Interna, Hospital de Cabueñes, Gijón, Asturias, Spain
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"apellidos" => "Ampudia-Blasco" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256518302558" "doi" => "10.1016/j.rce.2018.06.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256518302558?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418301966?idApp=WRCEE" "url" => "/22548874/0000022000000001/v1_202002130124/S2254887418301966/v1_202002130124/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Medicine in images</span>" "titulo" => "Reversible pulmonary toxicity by nitrofurantoin" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "69" "paginaFinal" => "70" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S.M. Santos Seoane, R. Fernández-Madera-Martínez, M.L. Taboada-Martínez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "S.M." "apellidos" => "Santos Seoane" "email" => array:1 [ 0 => "smsspulp@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Fernández-Madera-Martínez" ] 2 => array:2 [ "nombre" => "M.L." "apellidos" => "Taboada-Martínez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Interna, Hospital de Cabueñes, Gijón, Asturias, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Toxicidad pulmonar reversible por nitrofurantoína" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1060 "Ancho" => 2083 "Tamanyo" => 168686 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 72-year-old woman with recurrent urinary tract infections was undergoing long-term therapy with nitrofurantoin for the last 5 months. The patient was admitted for a weight loss of 6<span class="elsevierStyleHsp" style=""></span>kg in the 2 previous months and minimal effort dyspnea and associated morning cough. The auscultation revealed bibasilar crackles. Chest radiography showed a bilateral interstitial pattern (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, left), predominantly in the lower fields. The patient was started on diuretic therapy, which did not improve the condition radiologically or clinically and did not improve the auscultatory signs. High-resolution computed tomography confirmed the interstitial pattern, which was predominantly reticular and had a peribronchovascular and subpleural distribution (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, stars), with small subsegmental areas of ground-glass opacity (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, arrows). The pulmonary function tests revealed a significant reduction in diffusion (diffusing capacity of the lungs for carbon monoxide, 31%). We suspected interstitial impairment secondary to nitrofurantoin. The use of the drug was therefore discontinued. In the review 6 weeks later, we confirmed that the interstitial pattern had resolved in the radiography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, right), with clinical improvement and disappearance of the crackles.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Nitrofurantoin is an antibacterial used in acute cystitis and in the prophylaxis of recurrent urinary tract infections. Pulmonary toxicity can have an acute (approximately 9 days after a short treatment) or chronic (after months or years of therapy) onset.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Some 85–95% of cases occur in women. The common symptoms in the acute form are fever, dyspnea, irritative cough and skin rash. In the chronic form, the typical symptoms are dyspnea and dry cough, while fever is uncommon. By discontinuing the therapy, rapid regression of the symptoms and radiographic anomalies (days or weeks) can be observed in the acute form, while improvement is slower (weeks or months) for the chronic form.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-07-19" "fechaAceptado" => "2018-09-10" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Santos Seoane SM, Fernández-Madera-Martínez R, Taboada-Martínez ML. Toxicidad pulmonar reversible por nitrofurantoína. Rev Clin Esp. 2020;220:69–70.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1060 "Ancho" => 2083 "Tamanyo" => 168686 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 518 "Ancho" => 2083 "Tamanyo" => 206851 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022000000001/v1_202002130124/S2254887418301875/v1_202002130124/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000001/v1_202002130124/S2254887418301875/v1_202002130124/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418301875?idApp=WRCEE" ]
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