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Nitrofurantoin: cause of DRESS syndrome
  1. Rodrigo Nazário Leão1,
  2. Paulo Barreto1,
  3. Ricardo R Leão2,
  4. José Vaz Ribeiro1
  1. 1Department of Internal Medicine, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal
  2. 2Department of Urology and Renal Transplantation, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
  1. Correspondence to Dr Rodrigo Nazário Leão, rodrigoromaoleao{at}


Urinary tract infections (UTIs) are a common pathological entity among elderly patients. The widespread use of antibiotics for uncomplicated UTIs has gained many opponents mainly due to the increasing drug resistance observed. Nitrofurantoin is a commonly used antibacterial drug because it has low side effects and a good antiurinary bacterial profile. However, in this paper, we present a case of a nitrofurantoin-induced DRESS (drug reaction/rash with eosinophilia and systemic symptoms) syndrome in a 77-year-old woman. During UTI treatment, the patient developed an acute skin rash which spread all over the body and a considerable decrease in urine volume. At the emergency department, we found her developing eosinophilic pneumonia, anaemia and renal impairment that we relate to nitrofurantoin administration. To our knowledge, this is the second published case report which evokes nitrofurantoin as a possible cause of DRESS syndrome.

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