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See Latest ArticlesPoor medication history plus slow symptom onset delays a diagnosis
JAAPA, 10/20/09
Wilkin T et al. – An 89–year–old white female presented to the emergency department (ED) with a 1–month history of fatigue, nonproductive cough, and weakness, progressing over the previous 3 days to the point where she was unable to attend meals in her assisted living facility's cafeteria. Her cough was exacerbated with deep inspiratory effort. The patient denied fever, chills, night sweats, dyspnea, nausea, vomiting, weight loss, syncope, or chest pain...This case created a diagnostic dilemma for clinicians. The combination of poor documentation of home medications and the slow, insidious onset of symptoms associated with chronic nitrofurantoin–induced pulmonary toxicity delayed the diagnosis and the discontinuation of nitrofurantoin. Clinicians must carefully document all home medications and think to consider this adverse reaction in patients taking nitrofurantoin, particularly in those who present with pulmonary symptoms.
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