Nitrofurantoin: cause of DRESS syndrome

BMJ Case Rep. 2013 May 8;2013:bcr2013008991. doi: 10.1136/bcr-2013-008991.


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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anemia / chemically induced
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Drug Hypersensitivity Syndrome / etiology*
  • Exanthema / chemically induced
  • Female
  • Humans
  • Kidney Diseases / chemically induced
  • Nitrofurantoin / adverse effects*
  • Nitrofurantoin / therapeutic use
  • Pulmonary Eosinophilia / chemically induced
  • Urinary Tract Infections / drug therapy*
  • Urination / drug effects


  • Anti-Bacterial Agents
  • Nitrofurantoin