Akbar D H, Alamoudi O S
Department of Medicine, King Abdulaziz University Hosptial, PO Box 18298, Jeddah 21415, Kingdom of Saudi Arabia.
Saudi Med J. 2000 Nov;21(11):1081-4.
Bronchiolitis obliterans organizing pneumonia is a rare disease characterized by the presence of granulation tissue within alveolar ducts and alveoli. Most cases are idiopathic, but it may also be seen during resolution of viral or bacterial pneumonia (mycoplasma, legionella and chlamydia). It may present as a community acquired pneumonia which does not respond to antibiotics, which make the diagnosis very difficult. We described a 53-year old patient who presented with Bronchiolitis obliterans organizing pneumonia during the resolution of pseudomonas aeruginosa pneumonia. Initially there was slight improvement on antibiotics but later he became severely hypoxic and placed on mechanical ventilator. Diagnosis of Bronchiolitis obliterans organizing pneumonia was obtained with bronchoscopic lung biopsy. He showed an excellent response to steroid treatment. To our knowledge this is the first case of Bronchiolitis obliterans organizing pneumonia secondary to Pseudomonas aeruginosa pneumonia.
闭塞性细支气管炎并机化性肺炎是一种罕见疾病,其特征为在肺泡管和肺泡内存在肉芽组织。大多数病例为特发性,但在病毒性或细菌性肺炎(支原体、军团菌和衣原体)消散期也可能出现。它可能表现为对抗生素无反应的社区获得性肺炎,这使得诊断非常困难。我们描述了一名53岁患者,其在铜绿假单胞菌肺炎消散期出现闭塞性细支气管炎并机化性肺炎。最初使用抗生素后有轻微改善,但后来他出现严重低氧血症并接受机械通气。通过支气管镜肺活检确诊为闭塞性细支气管炎并机化性肺炎。他对类固醇治疗反应良好。据我们所知,这是首例继发于铜绿假单胞菌肺炎的闭塞性细支气管炎并机化性肺炎病例。