Adult respiratory distress syndrome associated with acute nitrofurantoin toxicity. Successful treatment with continuous positive airway pressure.

A case of adult respiratory distress syndrome associated with nitrofurantoin use is described. The patient was successfully managed with continuous positive airway pressure (CPAP) through a tightly fitting face mask; clinical deterioration followed discontinuation of the CPAP, with improvement occurring when it was restarted. Acute nitrofurantoin pleuropulmonary reactions are reviewed, and CPAP by face mask is discussed.