Newmarch William, Puopolo Angelica, Weiler Madina, Casserly Brian
University of Limerick, Graduate Entry Medical School.
Monaldi Arch Chest Dis. 2017 May 18;87(1):799. doi: 10.4081/monaldi.2017.799.
The following report outlines the case of a 76-year-old gentleman who presented to the hospital with acute interstitial pneumonitis, a rare and rapidly progressive type of idiopathic interstitial pneumonia. The patient initially presented with a three-week history of progressive shortness of breath and cough which was diagnosed as community acquired pneumonia. Treatment with oral antibiotics was unsuccessful resulting in re-presentation the following week with type one respiratory failure. Investigations revealed widespread inflammatory changes consistent with an acute inflammatory process. Intravenous steroids, antibiotics and antiviral medications were initiated before an urgent transfer to the intensive care unit was required for intubation. An open lung biopsy, in conjunction with the clinical picture, confirmed the diagnosis of acute interstitial pneumonitis. The significance of this report is to highlight the rapid and destructive clinical course of a rare type of pneumonitis, which initially presented as a routine and innocuous diagnosis in our patient.
以下报告概述了一名76岁男性患者的病例，该患者因急性间质性肺炎入院，这是一种罕见且进展迅速的特发性间质性肺炎。患者最初出现进行性气短和咳嗽三周，被诊断为社区获得性肺炎。口服抗生素治疗无效，导致第二周因Ⅰ型呼吸衰竭再次就诊。检查发现广泛的炎症改变，符合急性炎症过程。在紧急转至重症监护病房进行插管之前，开始使用静脉类固醇、抗生素和抗病毒药物。经皮肺活检结合临床表现，确诊为急性间质性肺炎。本报告的意义在于强调一种罕见肺炎类型的快速且具有破坏性的临床病程，在我们的患者中，其最初表现为常规且看似无害的诊断。
