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Recurrent nitrofurantoin-induced giant cell interstitial pneumonia: Case report and literature review.

Lee B, Balavenkataraman A, Sanghavi D, Walter K - Respir Med Case Rep (2015)

Bottom Line: Only two cases of GIP induced by nitrofurantoin have been reported in the medical literature.We are reporting a case of recurrent nitrofurantoin-induced GIP.Although extremely rare, GIP needs to be included in the differential diagnosis in patients with chronic nitrofurantoin use who present with respiratory illness.

View Article: PubMed Central - PubMed

Affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA.

ABSTRACT
Giant cell interstitial pneumonia (GIP) is a rare form of chronic interstitial pneumonia typically associated with hard metal exposure. Only two cases of GIP induced by nitrofurantoin have been reported in the medical literature. We are reporting a case of recurrent nitrofurantoin-induced GIP. Although extremely rare, GIP needs to be included in the differential diagnosis in patients with chronic nitrofurantoin use who present with respiratory illness.

No MeSH data available.


Related in: MedlinePlus

CT scan of the chest (during first hospitalization) shows pleural thickening and severe fibrotic changes with honeycombing in both lungs.
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fig2: CT scan of the chest (during first hospitalization) shows pleural thickening and severe fibrotic changes with honeycombing in both lungs.

Mentions: On physical examination, the patient appeared uncomfortable with moderate respiratory distress. Blood pressure was 110/65 mm Hg, heart rate was 85 beats per minute, temperature 97.3 F. He was tachypneic with respiratory rate at 30 breaths per minute and oxygen saturation of 93% at rest on room air. He had diminished breath sounds bilaterally with dry crackles, more prominent on the right side. Laboratory studies revealed a normal white blood cell count of 8.4 × 109/L (reference range: 4.4–5.7 × 109/L) with a normal differential. The chemistry panel was also within normal range. Erythrocyte sedimentation rate was over 140 mm/h (normal range: 1–15 mm/h for men). ANA screen was positive, but all other serologies for rheumatologic disorders were negative, including anti-double stranded DNA, Rheumatoid Factor, Scl-70, anti-centromere B, anti-Jo, anti-ribosomal P, anti-RNP, anti-Sm, anti-SS/A and SS/b and ACE level. Testing for HIV 1&2 and Quantiferon TB Gold was negative. CXR showed extensive basilar fibrosis, pleural thickening and possible basilar infiltrates (Fig. 1). Chest computed tomography (CT) scan with intravenous contrast showed severe fibrotic changes in both lungs, with honeycombing especially at the lung bases and diffuse pleural wall thickening (Fig. 2).


Recurrent nitrofurantoin-induced giant cell interstitial pneumonia: Case report and literature review.

Lee B, Balavenkataraman A, Sanghavi D, Walter K - Respir Med Case Rep (2015)

CT scan of the chest (during first hospitalization) shows pleural thickening and severe fibrotic changes with honeycombing in both lungs.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356049&req=5

fig2: CT scan of the chest (during first hospitalization) shows pleural thickening and severe fibrotic changes with honeycombing in both lungs.
Mentions: On physical examination, the patient appeared uncomfortable with moderate respiratory distress. Blood pressure was 110/65 mm Hg, heart rate was 85 beats per minute, temperature 97.3 F. He was tachypneic with respiratory rate at 30 breaths per minute and oxygen saturation of 93% at rest on room air. He had diminished breath sounds bilaterally with dry crackles, more prominent on the right side. Laboratory studies revealed a normal white blood cell count of 8.4 × 109/L (reference range: 4.4–5.7 × 109/L) with a normal differential. The chemistry panel was also within normal range. Erythrocyte sedimentation rate was over 140 mm/h (normal range: 1–15 mm/h for men). ANA screen was positive, but all other serologies for rheumatologic disorders were negative, including anti-double stranded DNA, Rheumatoid Factor, Scl-70, anti-centromere B, anti-Jo, anti-ribosomal P, anti-RNP, anti-Sm, anti-SS/A and SS/b and ACE level. Testing for HIV 1&2 and Quantiferon TB Gold was negative. CXR showed extensive basilar fibrosis, pleural thickening and possible basilar infiltrates (Fig. 1). Chest computed tomography (CT) scan with intravenous contrast showed severe fibrotic changes in both lungs, with honeycombing especially at the lung bases and diffuse pleural wall thickening (Fig. 2).

Bottom Line: Only two cases of GIP induced by nitrofurantoin have been reported in the medical literature.We are reporting a case of recurrent nitrofurantoin-induced GIP.Although extremely rare, GIP needs to be included in the differential diagnosis in patients with chronic nitrofurantoin use who present with respiratory illness.

View Article: PubMed Central - PubMed

Affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA.

ABSTRACT
Giant cell interstitial pneumonia (GIP) is a rare form of chronic interstitial pneumonia typically associated with hard metal exposure. Only two cases of GIP induced by nitrofurantoin have been reported in the medical literature. We are reporting a case of recurrent nitrofurantoin-induced GIP. Although extremely rare, GIP needs to be included in the differential diagnosis in patients with chronic nitrofurantoin use who present with respiratory illness.

No MeSH data available.


Related in: MedlinePlus