NITROFURANTOIN-INDUCED PULMONARY HEMORRHAGE IN A RENAL-TRANSPLANT RECIPIENT RECEIVING IMMUNOSUPPRESSIVE THERAPY - CASE-REPORT AND REVIEW OFTHE LITERATURE

A 33-year-old woman received a cadaveric renal transplant for focal se gmental glomerulosclerosis. Nitrofurantoin urinary prophylaxis was sta rted on postoperative day 13 but coughing and mild hemoptysis began 2 days later. Diffuse infiltrates and worsening hemoptysis led to intuba tion and open lung biopsy. Clinical course, culture results and pathol ogical evaluation excluded infectious etiologies and were consistent w ith a drug reaction. The case is described, and the literature on the nitrofurantoin pulmonary toxicity syndromes and pathophysiology is rev iewed.