FATAL CHOLESTATIC HEPATITIS AND MULTISYSTEM FAILURE ASSOCIATED WITH NITROFURANTOIN

Nitrofurantoin is a broad-spectrum antimicrobial agent that has found widespread use in the prophylaxis and treatment of urinary tract infections. Adverse effects have been cited predominantly in adults, with infrequent reports in children and adolescents. We recently diagnosed nitrofurantoin-induced erythema multiforme, cholestatic hepatitis, and acute pulmonary toxicity leading to adult respiratory distress syndrome (ARDS) in a 16-year-old girl. This case report serves to document the occurrence of hepatic, dermatologic, and fatal pulmonary reactions not previously reported and to arouse awareness of the drug’s toxicity in light of its frequent use. © 1993 Raven Press, Ltd., New York.