•  
  •  

Scholarly Commons > HCA Healthcare Journal > Vol. 5 > Iss. 6 (2024)

 

Keywords

altered mental status; drug-induced; leukocytosis; nitrofurantoin; systemic inflammatory response syndrome (SIRS); urinary tract infection (UTI); medication adverse effect

Disciplines

Emergency Medicine | Infectious Disease

Abstract

Background

Nitrofurantoin is a prevalent antibiotic used to treat urinary tract infections. Despite nitrofurantoin’s general safety, it can cause serious side effects, including acute pulmonary toxicity, fulminant hepatitis, and severe systemic inflammatory responses, which may mimic conditions such as ischemia and infection. However, reports of acute systemic inflammatory response syndrome after nitrofurantoin ingestion are uncommon in medical literature.

Case Presentation

This case describes a severe systemic inflammatory response syndrome in an 85-year-old woman presenting with hypoxia, altered mental status, and profound leukocytosis after exposure to a single dose of nitrofurantoin.

Conclusion

Herein we report on a patient with suspected bacteremia and urosepsis. Who was treated with broad-spectrum antibiotics. However, the antibiotic used to treat the patient’s urinary tract infection caused an altered mental status and systemic inflammatory response. Therefore, it is crucial for clinicians to consider iatrogenic and medication-induced etiologies for altered mental status.

Download

Share

COinS