NITROFURANTOIN-INDUCED ALTERATIONS IN PULMONARY TISSUE - REPORT ON 5 PATIENTS WITH ACUTE OR SUBACUTE REACTIONS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 85  (5) , 713-720
Abstract
Three patients with acute and 2 with subacute nitrofurantoin-induced pulmonary reactions were studied clinically and by examining microscopically needle biopsy specimens of their lungs. In all 5 patients, slight vasculitis and a few interstitial eosinophils were found in the pulmonary tissue 1-2 wk after the withdrawal of nitrofurantoin therapy. Alveolitis, fibrinous alveolar exudate and perivascular granulomas were also seen in some specimens. The patients with acute reactions had marked blood eosinophilia. In all patients, pulmonary diffusing capacity (DLCO) was below normal, but ventilatory function was not appreciably affected. Withdrawal of nitrofurantoin resulted in complete or partial improvement in 4-8 wk. Clinical and histological findings show that a type 3 immune-complex-mediated reaction is probably involved in acute and subacute hypersensitivity reactions to nitrofurantoin.