Nitrofurantoin
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Haematologic toxicity and acute liver injury: case report A 61-year-old-female developed haematologic toxicity and acute liver injury during treatment with nitrofurantoin for urinary tract infection (UTI) [duration of treatment to reaction onsets not stated]. The woman, who had history of diabetes mellitus and had undergone gastric sleeve surgery, presented due to nausea, malaise and right upper quadrant abdominal (RUQ) pain. A week a prior to presentation, she was initiated on nitrofurantoin [dosage and route not stated] for treating UTI. Few days prior to the presentation, she was switched to cephalexin because of worsening symptoms. Physical examination showed tenderness in the RUQ, febrile state and confusion. Laboratory tests showed absolute neutrophil count 0.8, WBC count 0.9, Hb 12.7, AST 4143, ALT 2501, platelet count 74, total bilirubin 1.9, ammonia 62, alkaline phosphatase 470, lactate 3.0, pro-thrombin time 17.8 and evidence of UTI. These values subsequently increased. The woman received a supportive treatment, after which her clinical status improved. Five days later, her haematological abnormalities. Also, liver function tests normalised two weeks later. She reported hospitalisation 2 years prior to this report due to the similar presentation. Upon further review, it was noted that nitrofurantoin use was between both the presentations. Deepak V, et al. Fast and the nitrofurious: Nitrofurantoin induced acute liver injury with concomitant hemotoxicity. American Journal of Respiratory and Critical Care Medicine 199: (plus poster) abstr. A4810, No. 9, May 2019. Available from: URL: https://www.atsjournals.org/doi/abs/10.1164/ajrccm803446306 conference.2019.199.1_MeetingAbstracts.A4810 [abstract]
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Reactions 18 Jan 2020 No. 1787
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