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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Systemic inflammatory response syndrome (SIRS) and a left bundle branch block (LBBB) due to nitrofurantoin
  1. Susheer Dilbagh Gandotra1,
  2. Mariola A Smotrys1,
  3. Darshan B Patel2,
  4. Akash Chadha1
  1. 1Infectious Diseases, Pocono Medical Center, East Stroudsburg, Pennsylvania, USA
  2. 2Sacred Heart Hospital, Allentown, Pennsylvania, USA
  1. Correspondence to Dr Susheer Dilbagh Gandotra, susheer.gandotra{at}lvhn.org

Summary

We present a case of a 74-year-old woman, who was on nitrofurantoin treatment for urinary tract infection (UTI), with fever and chills 7 hours after taking nitrofurantoin. She was hospitalised and evaluated for worsening UTI and sepsis. Initially, it appeared to be secondary to post-UTI sepsis because of possible resistant infection or conditions like pulmonary embolism or acute hepatitis. The patient also developed systemic inflammatory response syndrome, left bundle branch block (LBBB), thrombocytopaenia and transaminitis. Considering the side effects of nitrofurantoin, it was stopped. The patient showed improvement and recovered completely with symptomatic and supportive treatment. During follow-up visits with her primary care physician, thrombocytopaenia, transaminitisandLBBB were found to have been resolved.

  • Drugs and medicines
  • Infections
  • Urinary and genital tract disorders
  • Infectious diseases
  • Urinary tract infections

https://doi.org/10.1136/bcr-2016-218127

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    Footnotes

    • Contributors SDG conceived and conducted the study, SDG and MAS initiated the study design and conception, DBP and AC helped with implementation and acquisition of data, MAS was involved with design, SDG was involved with interpretation of data. All authors contributed to refinement of the study protocol and approved the final manuscript.

      We certify that neither this manuscript nor one with substantially similar content under our authorship has been published or is being considered for publication elsewhere.

      We have access to any data on which the manuscript is based and will provide such data on request to the editors or their assignees.

      We all agree to allow the corresponding author to correspond with the editorial office, to review the uncorrected proof copy of the manuscript, and to make decisions regarding release of information in the manuscript.

      We have given final approval of the submitted manuscript for which we take public responsibility for whole content.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.