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Nitrofurantoin-induced agranulocytosis
  1. Vanessa Lopes1,
  2. Joana Ramos2,
  3. Patrícia Dias2 and
  4. Arsénio Santos2
  1. 1Cardiology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
  2. 2Internal Medicine Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  1. Correspondence to Dr Vanessa Lopes;{at}


Idiosyncratic drug-induced agranulocytosis is a rare life-threatening adverse reaction characterised by an absolute neutrophil count <500 cells/μL of blood. Nitrofurantoin has been associated with haematological adverse events, but few agranulocytosis cases worldwide have been reported. We present a case of a 68-year-old woman who presented with fever and agranulocytosis following treatment with nitrofurantoin. Extensive workup for agranulocytosis, including a bone marrow aspirate, was unremarkable. Treatment with nitrofurantoin was discontinued, which led to a complete recovery of the complete blood count. This case stresses the importance of monitoring treatments, given that widely used drugs are not free from severe adverse reactions.

  • haematology (incl blood transfusion)
  • unwanted effects / adverse reactions
  • safety

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  • VL and JR are joint first authors.

  • VL and JR contributed equally.

  • Contributors VL and JR equally contributed to research, writing and editing (joint first authorship). PD and AS contributed to overall guidance, direction and editing. All authors read, edited and approved the final document prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

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