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Nitrofurantoin-induced lung disease — SCE Respiratory MCQ

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ModerateInterstitial Lung DiseaseNitrofurantoin-induced lung diseaseSCE Respiratory

A 55-year-old woman treated with nitrofurantoin prophylaxis for recurrent UTI develops progressive dyspnoea. HRCT shows bilateral ground-glass opacity and fine reticulation. Blood eosinophils are 0.7 x 10^9/L and symptoms improve after stopping nitrofurantoin. What is the most likely diagnosis?

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Correct answer: D — Nitrofurantoin-induced lung disease

Long-term nitrofurantoin can cause drug-induced interstitial lung disease, and improvement after withdrawal supports the diagnosis. IPF would not typically improve simply after stopping nitrofurantoin and would show a UIP pattern. Pneumonia would usually have fever, focal consolidation or microbiological evidence.

Reference: BNF; BTS ILD resources