Cryptogenic Organizing Pneumonia and Idiopathic Eosinophilic Pneumonia: A Case Report of Clinically Identical Entities

Buddhavarapu, Venkata Srihari; Dhillon, Gagandeep; Grewal, Harpreet; Kashyap, R.

doi:10.7759/cureus.40591

Cited by 2 publications

(3 citation statements)

References 10 publications

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Section: Discussionmentioning

confidence: 75%

“…When the radiologic findings show a peripheral predominance of infiltrates and eosinophilia, we narrow this to organizing pneumonia or eosinophilic pneumonia. One deciding factor for organizing pneumonia is the localization of infiltrates in the bases and subpleural regions along with mass-like lesions, like our case [5]. In general, when we treat patients with rapidly progressive hypoxia, bilateral interstitial infiltrates, and response to steroids, we think of idiopathic interstitial lung diseases.…”

Section: Discussionmentioning

confidence: 84%

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COVID-19 Pneumonia Presenting As Solitary Pulmonary Lesion

Valles-Bastidas,

Torre-De León,

Grosu

2023

Cureus

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Common findings of COVID-19 pneumonia on chest CT images include ground-glass opacities and organizing pneumonia. Here, we present a patient with a history of lung cancer who came to our center for re-staging CT studies, which showed a solitary peripheral lung mass suggestive of lung cancer. While being evaluated for the mass, the patient developed respiratory failure due to COVID-19 pneumonia. After treatment for COVID-19 and recovery, CT showed complete resolution of the solitary peripheral lung mass. This case highlights that COVID-19 can, on occasion, present with CT findings that mimic those of lung cancer.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 84%

COVID-19 Pneumonia Presenting As Solitary Pulmonary Lesion

Valles-Bastidas,

Torre-De León,

Grosu

2023

Cureus

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“…Given that there was no improvement despite the use of high dose steroids favored against the diagnosis of ILD and subtypes including cryptogenic organizing pneumonia (COP) and idiopathic eosinophilic pneumonia (IEP). [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

Pneumocystis jirovecii pneumonia: a case report

Gri,

Jain

2024

J Med Case Reports

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Introduction and importance Pneumocystis jirovecii (PJP) pneumonia is a serious life-threatening condition in immunocompromised individuals and is often associated with human immunodeficiency virus (HIV) + patients. We describe a case of PJP pneumonia which provided a diagnostic challenge in a patient who presented with no known risk factors leading to a delay in initiation of appropriate antibiotic therapy. Case presentation A 71-year-old previously healthy white/Caucasian male presented with subacute hypoxic respiratory failure due to multifocal pneumonia with diffuse bilateral ground glass opacities with consolidations despite prior treatment with antibiotics and steroids. He was admitted and started on intravenous broad-spectrum antibiotics but continued to deteriorate, eventually requiring intubation and transfer to the ICU. Bronchoscopy revealed PJP and treatment was initiated, but the patient developed refractory shock and multiorgan failure, and ultimately died. It was later discovered that he was HIV-1 positive. Clinical discussion PJP, as a potential cause of his presentation, was not considered given that our patient lacked any overt risk factors for PJP pneumonia. He continued to worsen despite broad spectrum antibiotic therapy and hence bronchoscopy was pursued. His clinical profile, in hindsight, was suspicious for PJP pneumonia and early PJP-directed antibiotic therapy may have prevented a fatal outcome, as in this case. There was an element of cognitive bias across multiple providers which may have contributed to the delay in treatment despite his rapid clinical decline while on conventional pneumonia treatment protocol. His diagnosis was later evident when his BAL-DFA grew PJP in addition to his low levels of CD4 and CD8 cells. He was found to be HIV-1 positive five days after his death; there was a delay in this diagnosis since all positive HIV tests from the hospital are reported as ‘pending’ until the presumptive positive sample goes to the Connecticut Department of Public Health State laboratory for the confirmatory test. PJP-targeted therapies were initiated later in our patient’s hospital course when the infection had progressed to refractory septic shock with multiorgan failure and eventual death. Conclusion PJP pneumonia is a fatal disease if not recognized early in the course of illness, and the patient usually undergoes multiple antibiotic regimens before they are diagnosed and receive appropriate clinical care. The gold standard of diagnostic testing for PJP is by obtaining bronchial washings through a flexible bronchoscopy and the turnaround time for such results may take a few days to result. A significant proportion of patients may not have any overt risk factors of immunosuppression and early empiric treatment for PJP may be clinically appropriate as the delay in diagnosis may be associated with significant morbidity and mortality risk.

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Cryptogenic Organizing Pneumonia and Idiopathic Eosinophilic Pneumonia: A Case Report of Clinically Identical Entities

Cited by 2 publications

References 10 publications

COVID-19 Pneumonia Presenting As Solitary Pulmonary Lesion

COVID-19 Pneumonia Presenting As Solitary Pulmonary Lesion

Pneumocystis jirovecii pneumonia: a case report

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