Hepatic Disorder and Severe Bleeding Diathesis Following Nitrofurantoin Ingestion

Severe but transient bleeding disorder and liver dysfunction followed oral ingestion of nitrofurantoin (Furandantin). The patient had prolonged nausea but no other apparent reaction to the drug. The liver disorder appeared to be toxic hepatitis rather than intrahepatic cholestasis, and the bleeding was due to deficiencies of prothrombin and of factor VII, which were in turn attributed to the hepatitis. Spontaneous bleeding into the neck necessitated tracheostomy after exchange transfusion.