- 期刊
長期使用Nitrofurantoin後造成慢性間質性肺炎及肺部纖維化：病例報告
Interstitial Pneumonitis and Pulmonary Fibrosis Secondary to Long-term Nitrofurantoin Therapy
摘要
Nitrofurantoin對肺部潛在的毒性首先在1956年被Rebhun所懷疑，他報告一位使用此藥的病人有發燒，胸痛，喘及抽血檢查有嗜伊紅血球增加的現象但病人胸部X光檢查為正常[1]。1957年Fisk報導因使用nitrofurantoin而發生一急性類過敏反應，包括急性發作的胸痛，喘，發燒及皮疹[2]。在1962年nitrofurantoin對肺部的毒性被Israel及Diamond證實[3]。Nitrofurantoin造成慢性肺部纖維化（chronic pulmonary fibrosis）的病例在國內少有報告，本文報告一病例，病患是位76歲男性，臨床表現以呼吸困難，運動後喘來表現，肺功能檢查為一嚴重拘限性肺病，支氣管鏡併切片檢查為慢性發炎，胸部電腦斷層檢查為間質性肺炎，在停用nitrofurantoin及prednisolone治療病人後，肺部X光片有明顯進步。
關鍵字
間質性肺炎並列摘要
A patient who developed interstitial pneumonitis following prolonged treatment with nitrofurantoin for chronic urinary tract infection was presented. He had received the drug for more than two years. His history recalled five months of progressive shortness of breath and nonproductive cough. Chest radiographs showed bilateral pulmonary infiltration, and a pulmonary function test showed severely restrictive ventilatory impairment. Bronchoscopic biopsies showed chronic inflammation. The symptoms and chest radiographs improved after documented steroid therapy. Review of the literature showed Two types of documented reactions: acute pulmonary hypersensitivity and chronic interstitial pneumonitis. The time has come for a re-evaluation of nitrofurantoin and its role in the treatment of urinary tract infection.