Reversible lung fibrosis in a 6-year-old girl after long term nitrofurantoin treatment.


Journal

BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563

Informations de publication

Date de publication:
26 Nov 2020
Historique:
received: 12 09 2020
accepted: 19 11 2020
entrez: 27 11 2020
pubmed: 28 11 2020
medline: 10 8 2021
Statut: epublish

Résumé

Pulmonary side effects are well known, including lung fibrosis, in elderly patients treated with long-term nitrofurantoin to prevent urinary tract infections and secondary renal injury. However, pulmonary side effects have only been reported rarely in paediatric cases, despite nitrofurantoin being a first line prophylactic treatment of recurrent childhood urinary tract infection. A 6-year-old girl was admitted to the hospital with dyspnea, general fatigue, loss of appetite and need for nasal oxygen treatment after long-term nitrofurantoin treatment. A computed tomography scan of the chest showed lung fibrosis. A biopsy confirmed this diagnosis. We suspected the fibrosis to be caused by the nitrofurantoin treatment. Thorough examinations reveal no other explanations. Nitrofurantoin was discontinued and the girl was treated with methylprednisolone. After 17 month a new scan and lung function test showed total regression of the lung fibrosis. This case underlines that risk of severe side effects should be taken in to account before initiation of long-term nitrofurantoin treatment in children.

Sections du résumé

BACKGROUND BACKGROUND
Pulmonary side effects are well known, including lung fibrosis, in elderly patients treated with long-term nitrofurantoin to prevent urinary tract infections and secondary renal injury. However, pulmonary side effects have only been reported rarely in paediatric cases, despite nitrofurantoin being a first line prophylactic treatment of recurrent childhood urinary tract infection.
CASE PRESENTATIONS METHODS
A 6-year-old girl was admitted to the hospital with dyspnea, general fatigue, loss of appetite and need for nasal oxygen treatment after long-term nitrofurantoin treatment. A computed tomography scan of the chest showed lung fibrosis. A biopsy confirmed this diagnosis. We suspected the fibrosis to be caused by the nitrofurantoin treatment. Thorough examinations reveal no other explanations. Nitrofurantoin was discontinued and the girl was treated with methylprednisolone. After 17 month a new scan and lung function test showed total regression of the lung fibrosis.
CONCLUSIONS CONCLUSIONS
This case underlines that risk of severe side effects should be taken in to account before initiation of long-term nitrofurantoin treatment in children.

Identifiants

pubmed: 33243181
doi: 10.1186/s12890-020-01353-x
pii: 10.1186/s12890-020-01353-x
pmc: PMC7689986
doi:

Substances chimiques

Anti-Infective Agents, Urinary 0
Nitrofurantoin 927AH8112L

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

313

Références

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Auteurs

Lise Fischer Mikkelsen (LF)

Department of Paediatrics and Adolescent Medicine, Danish Center of Paediatric Pulmonology and Allergology, Aarhus University Hospital, Aarhus N, Denmark. lisehr@rm.dk.

Sune Rubak (S)

Department of Paediatrics and Adolescent Medicine, Danish Center of Paediatric Pulmonology and Allergology, Aarhus University Hospital, Aarhus N, Denmark.

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Classifications MeSH