Department of Paediatrics and Adolescent Medicine, Danish Center of Paediatric Pulmonology and Allergology, Aarhus University Hospital, Aarhus N, Denmark.
BMC Pulm Med. 2020 Nov 26;20(1):313. doi: 10.1186/s12890-020-01353-x.
Pulmonary side effects are well known, including lung fibrosis, in elderly patients treated with long-term nitrofurantoin to prevent urinary tract infections and secondary renal injury. However, pulmonary side effects have only been reported rarely in paediatric cases, despite nitrofurantoin being a first line prophylactic treatment of recurrent childhood urinary tract infection.
A 6-year-old girl was admitted to the hospital with dyspnea, general fatigue, loss of appetite and need for nasal oxygen treatment after long-term nitrofurantoin treatment. A computed tomography scan of the chest showed lung fibrosis. A biopsy confirmed this diagnosis. We suspected the fibrosis to be caused by the nitrofurantoin treatment. Thorough examinations reveal no other explanations. Nitrofurantoin was discontinued and the girl was treated with methylprednisolone. After 17 month a new scan and lung function test showed total regression of the lung fibrosis.
This case underlines that risk of severe side effects should be taken in to account before initiation of long-term nitrofurantoin treatment in children.
长期使用呋喃妥因预防尿路感染和继发肾损伤可导致老年患者出现肺部副作用，包括肺纤维化。然而，尽管呋喃妥因是预防儿童复发性尿路感染的一线药物，但在儿科病例中，肺部副作用的报道却很少见。
一名 6 岁女孩因长期使用呋喃妥因治疗后出现呼吸困难、全身乏力、食欲不振和需要鼻氧疗而入院。胸部 CT 扫描显示肺纤维化。活检证实了这一诊断。我们怀疑纤维化是由呋喃妥因治疗引起的。全面检查未发现其他解释。停用了呋喃妥因，并用甲基强的松龙对女孩进行治疗。17 个月后，新的扫描和肺功能测试显示肺纤维化完全消退。
本病例强调，在开始儿童长期呋喃妥因治疗之前，应考虑严重副作用的风险。
