Nitrofurantoin-induced agranulocytosis

BMJ Case Rep. 2021 Nov 11;14(11):e246788. doi: 10.1136/bcr-2021-246788.

Abstract

Idiosyncratic drug-induced agranulocytosis is a rare life-threatening adverse reaction characterised by an absolute neutrophil count <500 cells/μL of blood. Nitrofurantoin has been associated with haematological adverse events, but few agranulocytosis cases worldwide have been reported. We present a case of a 68-year-old woman who presented with fever and agranulocytosis following treatment with nitrofurantoin. Extensive workup for agranulocytosis, including a bone marrow aspirate, was unremarkable. Treatment with nitrofurantoin was discontinued, which led to a complete recovery of the complete blood count. This case stresses the importance of monitoring treatments, given that widely used drugs are not free from severe adverse reactions.

Keywords: haematology (incl blood transfusion); safety; unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Cell Count
  • Female
  • Humans
  • Leukocyte Count
  • Neutropenia*
  • Neutrophils
  • Nitrofurantoin* / adverse effects

Substances

  • Nitrofurantoin