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A case report of fungal infection associated acute fibrinous and organizing pneumonitis
BACKGROUND: Acute fibrinous and organizing pneumonitis (AFOP) is an uncommon variant of acute lung injury, characterized by intra-alveolar fibrin and organizing pneumonia. Proposed etiologies include connective tissue diseases, infections, occupational exposure, drug reactions, and autoimmune diseas...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171735/ https://www.ncbi.nlm.nih.gov/pubmed/32312262 http://dx.doi.org/10.1186/s12890-020-1145-7 |
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author | Zhao, Jiangnan Shi, Yi Yuan, Dongmei Shi, Qunli Wang, Weiping Su, Xin |
author_facet | Zhao, Jiangnan Shi, Yi Yuan, Dongmei Shi, Qunli Wang, Weiping Su, Xin |
author_sort | Zhao, Jiangnan |
collection | PubMed |
description | BACKGROUND: Acute fibrinous and organizing pneumonitis (AFOP) is an uncommon variant of acute lung injury, characterized by intra-alveolar fibrin and organizing pneumonia. Proposed etiologies include connective tissue diseases, infections, occupational exposure, drug reactions, and autoimmune disease. Here we present a rare case of fungal infection associated AFOP in patient with diabetes mellitus (DM) and review the relevant literature. CASE PRESENTATION: A 67-year-old man complained of cough, fever, dyspnea and hemoptysis. Patient experienced a rapidly progressive course exhibit diffuse predominant consolidation, ground glass opacities, and multifocal parenchymal abnormalities on chest computed tomography (CT). Antibacterial, antifungal, and antiviral treatments were ineffective. A CT-guided percutaneous lung biopsy was performed. Histologically, the predominant findings were as follows: alveolar spaces filled with fibrin and organizing loose connective tissues involving 70% of the observed region, pulmonary interstitial fibrosis, and small abscesses and epithelioid cell granuloma in the focal area. Result of periodic acid-silver methenamine stain was positive. The fungal pathogen from the sputum culture was identified as P. citrinum repeatedly over 3 times. Patient was diagnosed with DM during hospitalization. Corticosteroids combined with an antifungal therapy were effective. Follow-up for 4 months showed complete radiological resolution. CONCLUSIONS: As this common “contaminant” can behave as a pathogen in the immunocompromised host, both clinicians and microbiologists should consider the presence of a serious and potentially fatal fungal infection on isolation of P. citrinum. Based on this case, it could be speculated that AFOP may be associated with fungal infection including P. citrinum. |
format | Online Article Text |
id | pubmed-7171735 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-71717352020-04-24 A case report of fungal infection associated acute fibrinous and organizing pneumonitis Zhao, Jiangnan Shi, Yi Yuan, Dongmei Shi, Qunli Wang, Weiping Su, Xin BMC Pulm Med Case Report BACKGROUND: Acute fibrinous and organizing pneumonitis (AFOP) is an uncommon variant of acute lung injury, characterized by intra-alveolar fibrin and organizing pneumonia. Proposed etiologies include connective tissue diseases, infections, occupational exposure, drug reactions, and autoimmune disease. Here we present a rare case of fungal infection associated AFOP in patient with diabetes mellitus (DM) and review the relevant literature. CASE PRESENTATION: A 67-year-old man complained of cough, fever, dyspnea and hemoptysis. Patient experienced a rapidly progressive course exhibit diffuse predominant consolidation, ground glass opacities, and multifocal parenchymal abnormalities on chest computed tomography (CT). Antibacterial, antifungal, and antiviral treatments were ineffective. A CT-guided percutaneous lung biopsy was performed. Histologically, the predominant findings were as follows: alveolar spaces filled with fibrin and organizing loose connective tissues involving 70% of the observed region, pulmonary interstitial fibrosis, and small abscesses and epithelioid cell granuloma in the focal area. Result of periodic acid-silver methenamine stain was positive. The fungal pathogen from the sputum culture was identified as P. citrinum repeatedly over 3 times. Patient was diagnosed with DM during hospitalization. Corticosteroids combined with an antifungal therapy were effective. Follow-up for 4 months showed complete radiological resolution. CONCLUSIONS: As this common “contaminant” can behave as a pathogen in the immunocompromised host, both clinicians and microbiologists should consider the presence of a serious and potentially fatal fungal infection on isolation of P. citrinum. Based on this case, it could be speculated that AFOP may be associated with fungal infection including P. citrinum. BioMed Central 2020-04-20 /pmc/articles/PMC7171735/ /pubmed/32312262 http://dx.doi.org/10.1186/s12890-020-1145-7 Text en © The Author(s). 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Zhao, Jiangnan Shi, Yi Yuan, Dongmei Shi, Qunli Wang, Weiping Su, Xin A case report of fungal infection associated acute fibrinous and organizing pneumonitis |
title | A case report of fungal infection associated acute fibrinous and organizing pneumonitis |
title_full | A case report of fungal infection associated acute fibrinous and organizing pneumonitis |
title_fullStr | A case report of fungal infection associated acute fibrinous and organizing pneumonitis |
title_full_unstemmed | A case report of fungal infection associated acute fibrinous and organizing pneumonitis |
title_short | A case report of fungal infection associated acute fibrinous and organizing pneumonitis |
title_sort | case report of fungal infection associated acute fibrinous and organizing pneumonitis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171735/ https://www.ncbi.nlm.nih.gov/pubmed/32312262 http://dx.doi.org/10.1186/s12890-020-1145-7 |
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