Acute fibrinous and organizing pneumonia masquerading as a lower respiratory tract infection: A case report and review of the literature

被引：16

作者：

Akhtar A. ^{[1
]}

Abideen Z.U. ^{[2
]}

机构：

[1] Department of Pulmonology and Critical Care, Shifa International Hospital, Islamabad

[2] Resident Internal Medicine, Department of Internal Medicine, Shifa International Hospital, Islamabad

来源：

BMC Research Notes | / 8卷 / 1期

关键词：

Acute fibrinous and organizing pneumonia (AFOP); Computerized tomography (CT) guided biopsy;

D O I：

10.1186/s13104-015-0984-4

中图分类号：

学科分类号：

摘要：

Background: Acute Fibrinous and Organizing Pneumonia is a rare entity characterized by the histological pattern suggestive of diffuse alveolar damage, eosinophilic pneumonia and organizing pneumonia; the presence of intra alveolar "fibrin balls" distinguishes it from these conditions. Herein, we describe the association of acute fibrinous and organizing pneumonia with a respiratory tract infection. We believe that such an association has been extremely rarely described. Case presentation: We report the case of a 68 year old female patient of Afghan descent who presented with shortness of breath, cough and high grade fever not responding satisfactorily to standard antibiotic therapy. Imaging revealed bilateral basilar infiltrates and ground glass opacification of the right lower lung zone. Though the inflammatory markers decreased with antibiotic therapy, there was minimal improvement in the patient's symptoms and radiological appearance of the lungs. Bronchoscopy was refused by the patient's family and a Computed Tomography guided biopsy of the lung revealed a histological diagnosis of acute fibrinous and organizing pneumonia. Patient was initiated on high dose intravenous corticosteroid therapy followed by a maintenance dose of prednisolone at 40 mg/day. She recovered dramatically. However, due to poor compliance with treatment, she relapsed and was re-treated with the same regimen. Currently she is completely symptom free and is on a tapering corticosteroid dose. Conclusion: We conclude that AFOP may be a rare but under diagnosed entity and recommend that it should be considered in the differentials of a suspected pulmonary infection unresponsive to optimum antibiotic therapy. © 2015 Akhtar and Abideen.

引用

共 19 条

[1]

Beasley M.B., Franks T.J., Galvin J.R., Gochuico B., Travis W.D., Acute fibrinous and organizing pneumonia: A histological pattern of lung injury and possible variant of diffuse alveolar damage, Arch Pathol Lab Med, 126, pp. 1064-1070, (2002)

[2]

Tzouvelekis A., Koutsopoulos A., Oikonomou A., Froudarakis M., Zarogoulidis P., Steiropoulos P., Et al., Acute fibrinous and organizing pneumonia: A case report and review of the literature, J Med Case Reports, 3, (2009)

[3]

Qiu Y.Y., Miao L.Y., Cai H.R., Xiao Y.L., Ye Q., Meng F.Q., Et al., The clinicopthological features of acute fibrinous and organizing pneumonia, Zhonghua Jie He He Hu Xi Za Zhi, 36, pp. 425-430, (2013)

[4]

Cincotta D.R., Sebira N.J., Lim E., Peters M.J., Fatal acute fibrinous and organizing pneumonia in an infant: The histopathological variability of acute respiratory distress syndrome, Pediatr Crit Care Med, 8, pp. 378-382, (2007)

[5]

Prahalad S., Bohnsack J.F., Maloney C.G., Leslie K.O., Fatal acute fibrinous and organizing pneumonia in a child with juvenile dermatomyositis, J Pediatr, 146, pp. 289-292, (2005)

[6]

Lopez-Cuenca S., Morales-Garcia S., Martin-Hita A., Frutos-Vivar F., Fernandez-Segoviano P., Esteban A., Severe acute respiratory failure secondary to acute fibrinous and organizing pneumonia requiring mechanical ventilation: A case report and literature review, Respir Care, 57, pp. 1337-1341, (2012)

[7]

Rapaka V., Hussain M.A., Niazi M., Diaz-Fuentes G., Severe acute fibrinous and organizing pneumonia causing acute respiratory distress syndrome and shock, J Bronchology Interv Pulmonol, 18, pp. 269-273, (2011)

[8]

Otto C., Huzly D., Huttel A., Benk C., Rieg S., Ploenes T., Et al., Acute fibrinous and organizing pneumonia associated with influenza A/H1N1 pneumonia after lung transplantation, BMC Pulm Med, 19, 13, (2013)

[9]

Valim V., Rocha R.H., Couto R.B., Paixao T.S., Serrano E.V., Acute fibrinous and organizing pneumonia and undifferentiated connective tissue disease: A case report, Case Report Rheumatol, 2012, (2012)

[10]

Hariri L.P., Unizony S., Stone J., Mino-Kenudson M., Sharma A., Matsubara O., Et al., Acute fibrinous and organizing pneumonia in systemic lupus erythematosus: A case report and review of the literature, Pathol Int, 60, pp. 755-759, (2010)

← 1 2 →