Abstract
A house wife of 51 year old, being treated for rheumatoid arthritis (Definite RA, Class 1, Stage 1), was complicated with acute cystitis. After ten days treatment with nitrofurantoin (Furadantin C®300mg a day), she suddenly noted general fatigue, polyarthralgic pain, chills, fever of 38.3°C, coughs, chest pain and vomiting. Physical examination revealed crepitant rales at the right lower back, and chest roentgenogram showed homogeneous exudative shadows at the bilateral lung bases. As these symptomes disappeared within several days, she again took one hundred mg of nitrofurantoin which resulted in exactly the same episode begining in two hours. Eosinophilia of 604per mm3 and transient elevation of serum IgE of 3, 200 U/ml, together with initiation of symptomes after 2 hours of ingestion, may indicate participation of immediate type hypersensivity in acute nitrofurantoin reaction.
