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a Respiratory
Services, Green Lane Hospital, Green Lane West, Auckland 3, New Zealand, b Department of Pathology
Correspondence to: Dr J Kolbe
Received 25 November 1997; Returned to authors 19 January 1998; Revised version received 2 June 1998; Accepted for publication 10 July 1998
The spectrum of nitrofurantoin lung injury continues to widen.
The case histories are presented of two patients who developed lung
disease associated with the use of nitrofurantoin with histological features of bronchiolitis obliterans organising pneumonia (BOOP), a
rare but recognised form of drug induced injury. The two middle aged
women presented with respiratory symptoms after prolonged treatment
with nitrofurantoin. Both had impaired lung function and abnormal
computed tomographic scans, and their condition improved when
nitrofurantoin was withdrawn and corticosteroid treatment commenced.
The favourable outcome in these two patients contrasts with the fatal
outcome of the two other reported cases of nitrofurantoin induced BOOP.
We suggest that the previous classification of nitrofurantoin induced
lung injury into "acute" and "chronic" injury is an
oversimplification in view of the wide variety of pathological entities
that have subsequently emerged.
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