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1.
Respiration ; 81(5): 433-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21051872

RESUMO

Organizing pneumonia is a pathologic entity characterized by intra-alveolar buds of granulation tissue that can extend to the bronchiolar lumen. It is a non-specific finding reflecting a pattern of pulmonary response to aggression that can be cryptogenic or associated with several causes. Pulmonary actinomycosis is a rare infectious disease, of bacterial aetiology, and of difficult diagnosis. This disease usually causes non-specific respiratory symptoms and radiological findings, and the treatment is based on the use of antibiotics. The authors describe a clinical case of a 53-year-old male smoker (50 pack years), initially seen for complaints of right-sided chest pain and sub-febrile temperature. Imaging studies revealed a mass in the inferior right lobe and enlarged mediastinal lymph nodes. Empirical treatment with antibiotics caused partial and temporary improvement. Transthoracic biopsy revealed a pattern of organizing pneumonia with giant multinucleated cell granulomas. Repeat imaging studies revealed an enlargement of the pulmonary mass and therefore a right inferior lobectomy was performed. The pathologic study revealed a histological pattern of organizing pneumonia surrounding inflammatory bronchiectasis with a large number of Actinomyces colonies. To our knowledge there is presently no report in the literature of organizing pneumonia associated with Actinomyces infection.


Assuntos
Actinomicose/complicações , Pneumonia em Organização Criptogênica/etiologia , Pneumonia em Organização Criptogênica/microbiologia , Pneumopatias/complicações , Bronquiectasia/complicações , Pneumonia em Organização Criptogênica/patologia , Pneumonia em Organização Criptogênica/fisiopatologia , Pneumonia em Organização Criptogênica/cirurgia , Granuloma de Células Gigantes/complicações , Granuloma de Células Gigantes/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonectomia , Testes de Função Respiratória , Tomografia Computadorizada por Raios X
2.
Respir Care ; 56(12): 1959-61, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21682987

RESUMO

Mycobacterium kansasii disease was diagnosed in an 85-year-old woman admitted to the hospital for cough and gradually worsening breathlessness. Transbronchial biopsy indicated either non-necrotizing granulomata or bronchiolitis obliterans organizing pneumonia (BOOP). She was cured with combined therapy of specific anti-mycobacterial medications and systemic steroids. To our knowledge, this is the first report of M. kansasii non-tuberculous mycobacterium disease with a BOOP-like pattern on lung biopsy.


Assuntos
Pneumonia em Organização Criptogênica/etiologia , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/patologia , Mycobacterium kansasii , Idoso de 80 Anos ou mais , Brônquios/patologia , Pneumonia em Organização Criptogênica/microbiologia , Feminino , Granuloma/patologia , Humanos , Imuno-Histoquímica , Queratinas/metabolismo , Derrame Pleural/diagnóstico por imagem , Tomografia Computadorizada por Raios X
3.
Trop Doct ; 51(2): 261-263, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33050840

RESUMO

Connective tissue diseases and infections are amongst the causes for organising pneumonia. However, organising pneumonia preceding other connective tissue disease manifestations is rare. Mycobacterium tuberculosis is rarely associated with organising pneumonia. We report such a case. A 50-year-old diabetic male, a roadside shop keeper, a current smoker presented with fever, breathlessness, cough and weight loss for four months. Chest radiography demonstrated areas of consolidation with halo signs. Anti-nuclear antibody blot was positive for Scl-70 and Jo-1 suggestive of a syndrome of systemic sclerosis and polymyositis overlap. Fibre-optic bronchoscopy guided lung biopsy was suggestive of organising pneumonia, and broncho-alveolar lavage detected Mycobacterium tuberculosis. Mycobacterium tuberculosis should be investigated as an aetiology of organising pneumonia, as this may occur in unestablished cases of connective tissue disease even before clinical and radiological manifestations appear, as response can be achieved with anti-tuberculosis therapy alone, without additional use of systemic steroids.


Assuntos
Doenças do Tecido Conjuntivo/diagnóstico , Tuberculose/complicações , Doenças do Tecido Conjuntivo/microbiologia , Pneumonia em Organização Criptogênica/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação
4.
J Infect Chemother ; 16(3): 206-9, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20169387

RESUMO

The most frequent manifestations of Cryptococcus neoformans (CN) disease are systemic infections in immunocompromised patients and localized pulmonary disease in immunocompetent individuals. Such pulmonary cryptococcosis can range from asymptomatic infection to frank pneumonia that can be severe. Bronchiolitis obliterans organizing pneumonia (BOOP) is a rare severe form of pneumonitis caused by a variety of infectious and toxic agents or connective tissue diseases. BOOP due to Cryptococcus neoformans has very rarely been reported; there have been only five such case reports, mostly in immunocompromised patients. We report herein on a case of CN-associated BOOP in an immunocompetent individual and discuss the diagnosis and treatment of this entity.


Assuntos
Cryptococcus neoformans/isolamento & purificação , Pneumonia em Organização Criptogênica/microbiologia , Adulto , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Histocitoquímica , Humanos , Imunocompetência , Pulmão/microbiologia , Masculino , Radiografia Torácica , Tomografia Computadorizada por Raios X
5.
Transpl Infect Dis ; 10(5): 339-42, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18248564

RESUMO

We report a patient who presented 6 months after orthotopic liver transplantation (OLT) with fever, dyspnea, and pulmonary infiltrates with biopsy-confirmed Pneumocystis jiroveci infection associated with a process of bronchiolitis obliterans organizing pneumonia (BOOP). We present this second case of BOOP associated with P. carinii pneumonia after OLT to highlight the risk of such disease combination in all transplant patients as well as discuss the protective effect of post-transplant prednisolone with trimethoprim-sulfamethoxazole prophylaxis and the possible duration of prophylaxis.


Assuntos
Pneumonia em Organização Criptogênica/diagnóstico , Transplante de Fígado/efeitos adversos , Pneumocystis carinii , Pneumonia por Pneumocystis/diagnóstico , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Biópsia , Pneumonia em Organização Criptogênica/tratamento farmacológico , Pneumonia em Organização Criptogênica/etiologia , Pneumonia em Organização Criptogênica/microbiologia , Diagnóstico Diferencial , Quimioterapia Combinada , Hepatite Alcoólica/terapia , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Pneumonia/patologia , Pneumonia por Pneumocystis/tratamento farmacológico , Pneumonia por Pneumocystis/etiologia , Pneumonia por Pneumocystis/microbiologia , Prednisolona/uso terapêutico , Radiografia , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
6.
Intern Med ; 54(8): 945-51, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25876578

RESUMO

We herein report our experience with patients who had nontuberculous mycobacterial lung disease (NTM disease) accompanied by organizing pneumonia (OP). Out of 98 NTM disease patients who had undergone a biopsy or surgical resection, 11 patients had OP that was revealed histologically. After excluding six patients who had OP-related diseases (idiopathic interstitial pneumonia, rheumatoid arthritis, etc.), the remaining five patients were studied. Two of them (a 73-year-old man and a 66-year-old woman) showed common clinical feature: acute-onset symptoms of cough and fever, infiltrating shadows and dramatic improvement following treatment with a corticosteroid and anti-mycobacterial therapy. Our cases demonstrate that NTM disease is sometimes accompanied by OP histologically, and some such cases show common clinical features.


Assuntos
Corticosteroides/administração & dosagem , Líquido da Lavagem Broncoalveolar/microbiologia , Pneumonia em Organização Criptogênica/complicações , Pulmão/microbiologia , Infecções por Mycobacterium não Tuberculosas/complicações , Idoso , Tosse/complicações , Pneumonia em Organização Criptogênica/tratamento farmacológico , Pneumonia em Organização Criptogênica/microbiologia , Pneumonia em Organização Criptogênica/patologia , Feminino , Humanos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/patologia
7.
Chest ; 115(4): 1188-94, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10208228

RESUMO

STUDY OBJECTIVES: To characterize adult Mycoplasma pneumoniae-induced bronchiolitis requiring hospitalization. DESIGN: We encountered an adult patient with severe bronchiolitis in the absence of pneumonia due to M. pneumoniae. To determine the relative frequency of such a condition, we retrospectively reviewed the medical records of adults over a 4-year period with a hospital discharge diagnosis of "bronchiolitis" from a university hospital. SETTING: University Hospital of the University of Colorado Health Sciences Center, Denver, CO. STUDY SUBJECTS: From 1994 to 1998, 10 adult inpatients were identified with a diagnosis of bronchiolitis. There were two with respiratory bronchiolitis, one with panbronchiolitis, one patient with bronchiolitis obliterans organizing pneumonia (BOOP), and six with acute inflammatory bronchiolitis. Including the initial patient, three had a definitive clinical diagnosis of Mycoplasma-associated bronchiolitis. RESULTS: The three adult patients with bronchiolitis due to M. pneumoniae are unusual because they occurred in the absence of radiographic features of a lobar or patchy alveolar pneumonia. Hospital admission was occasioned by the severity of symptoms and gas exchange abnormalities. One patient had bronchiolitis as well as organizing pneumonia (BOOP) that responded favorably to corticosteroid treatment. The other two had high-resolution CT findings diagnostic of an acute inflammatory bronchiolitis. One of the patients with inflammatory bronchiolitis had an unusual pattern of marked ventilation and perfusion defects localized predominantly to the left lung. All three had restrictive ventilatory impairment on physiologic testing. CONCLUSIONS: In adults, Mycoplasma-associated bronchiolitis without pneumonia is rarely reported, but in hospitalized patients, it may be more common than expected and may be associated with severe physiologic disturbances.


Assuntos
Bronquiolite/etiologia , Infecções por Mycoplasma/complicações , Mycoplasma pneumoniae , Adulto , Bronquiolite/diagnóstico , Bronquiolite/microbiologia , Bronquiolite/terapia , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/etiologia , Pneumonia em Organização Criptogênica/microbiologia , Pneumonia em Organização Criptogênica/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/terapia , Estudos Retrospectivos
8.
Pathol Res Pract ; 195(2): 89-92, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10093827

RESUMO

Lung volume reduction surgery (LVRS) yields resection specimens from patients with advanced pulmonary emphysema. Regarding the development of lung function parameters, recent results obtained by light microscopy revealed an unfavorable prognosis in patients with remarkable inflammation, particularly in the bronchioli. Tissue from ten patients (alpha1-antitrypsin level in the normal range) was furthermore investigated by electron microscopy. Scanning electron microscopy shows 0.4-0.6 micron spherical bodies variably densely arranged in the whole alveolar space and in the bronchioles of all patients. These bodies are mostly seen on the microvilli of type II pneumocytes. An immunological reaction with activation of macrophages and granulocytes occurs simultaneously. Macrophages show cytoplasmic extensions to the spherical bodies, which exhibit a cellular membrane but no cellular wall. This favors the diagnosis of bacterial colonization of the alveolar space and the bronchioles by mycoplasmas or L-forms of other bacteria. As patients undergoing lung volume reduction surgery are under optimal medical treatment and without any infection clinically, these findings appear to be relevant for the pathogenesis and/or progression of pulmonary emphysema.


Assuntos
Infecções Bacterianas/microbiologia , Brônquios/microbiologia , Pneumonia em Organização Criptogênica/microbiologia , Alvéolos Pulmonares/microbiologia , Enfisema Pulmonar/microbiologia , Doença Aguda , Linfócitos B/imunologia , Infecções Bacterianas/patologia , Infecções Bacterianas/cirurgia , Brônquios/ultraestrutura , Doença Crônica , Pneumonia em Organização Criptogênica/patologia , Pneumonia em Organização Criptogênica/cirurgia , Humanos , Microscopia Eletrônica de Varredura , Microvilosidades/ultraestrutura , Pneumonectomia , Alvéolos Pulmonares/ultraestrutura , Enfisema Pulmonar/patologia , Enfisema Pulmonar/cirurgia , Linfócitos T/imunologia , alfa 1-Antitripsina/análise
9.
An Med Interna ; 19(3): 133-5, 2002 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-12012761

RESUMO

Bronchitis obliterans organizing pneumonia (BOOP) is an unusual pulmonary condition. The clinical features and the radiologic findings are useful for the diagnosis of BOOP. However it is necessary to confirm its presence by an open or transbronchial pulmonary biopsy specimen. BOOP is usually idiopathic, although it may also occur in association with connective tissue disease, some haematologic disorders and in response to viral infections. The association of Legionella pneumophila infection with BOOP is very rare.


Assuntos
Pneumonia em Organização Criptogênica/microbiologia , Doença dos Legionários , Humanos , Masculino , Pessoa de Meia-Idade
10.
Pneumonol Alergol Pol ; 72(3-4): 99-104, 2004.
Artigo em Polonês | MEDLINE | ID: mdl-15757271

RESUMO

Organizing pneumonia (OP) is a rarely diagnosed disease, however the incidence ratio was estimated as 6-7/100000. Disease can occur in cryptogenic form or as a secondary reaction to various noxious agents, drugs, and ionising radiation, as a concomitant disease to infections, lympho- and myeloproliferative disorders, and connective tissue diseases. Symptoms of OP are non-specific therefore lung biopsy and histological examination are necessary for diagnosis. Eighteen cases of OP, 15 women and 3 men, aged 40 to 76 years, are presented with analysis of clinicopathological characteristic and therapeutic problems. In all cases diagnosis was confirmed by open lung biopsy. In one case radiotherapy and in one trastuzumab treatment was the cause of OP. In further 3 women antibodies against Chlamydia pneumoniae and in one--against Mycoplasma pneumoniae were found in serum. Probably Hashimoto disease was the cause of one case. In 12 patients the OP was idiopathic. Majority of patients were treated by prednisone (0.5 mg/kg). In one patient regression without any treatment was noticed and in other one--after cessation of trastuzumab. Five women were treated by clarithromycin. In 3 of them regression was observed but in other 2 corticotherapy was necessary. The observation period ranged from 1 month to 9 years, mean 34 months.


Assuntos
Pneumonia em Organização Criptogênica , Adulto , Idoso , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Biópsia , Claritromicina/uso terapêutico , Pneumonia em Organização Criptogênica/tratamento farmacológico , Pneumonia em Organização Criptogênica/microbiologia , Pneumonia em Organização Criptogênica/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
11.
J Med Microbiol ; 61(Pt 8): 1156-1158, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22516132

RESUMO

We report what is believed to be the first case of pulmonary Actinomyces graevenitzii infection presenting as organizing pneumonia. Fever and night sweats developed in a 69-year-old male. The only abnormal laboratory data were an elevated erythrocyte sedimentation rate and C-reactive protein level. On chest images, multiple consolidations with air bronchograms were seen in the bilateral lungs. Histological examination from lung biopsy revealed a pattern of organizing pneumonia with microabscesses, but definitive diagnosis was not obtained because culture from lung specimen was negative. A. graevenitzii was eventually identified in the lung biopsy specimen by detection of an Actinomyces-specific PCR product followed by 16S rRNA gene sequencing. The patient was treated with high-dose ampicillin intravenously for 1 month, followed by oral amoxicillin and clarithromycin for 6 months, and recovered. We suggest that actinomycosis can present as organizing pneumonia, and identification of infection by PCR analysis and rRNA gene sequencing is a useful strategy in cases that are difficult to diagnose.


Assuntos
Actinomyces/isolamento & purificação , Actinomicose/diagnóstico , Actinomicose/patologia , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/patologia , Reação em Cadeia da Polimerase/métodos , Actinomyces/classificação , Actinomyces/genética , Actinomicose/tratamento farmacológico , Actinomicose/microbiologia , Idoso , Amoxicilina/administração & dosagem , Ampicilina/administração & dosagem , Antibacterianos/administração & dosagem , Técnicas Bacteriológicas/métodos , Biópsia , Sedimentação Sanguínea , Proteína C-Reativa/análise , Claritromicina/administração & dosagem , Pneumonia em Organização Criptogênica/tratamento farmacológico , Pneumonia em Organização Criptogênica/microbiologia , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Histocitoquímica , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Dados de Sequência Molecular , RNA Ribossômico 16S/genética , Radiografia Torácica , Análise de Sequência de DNA , Tomografia Computadorizada por Raios X , Resultado do Tratamento
14.
Respiration ; 70(5): 507-14, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14665777

RESUMO

BACKGROUND: The role of infection as a cause of focal organizing pneumonia (OP) is not fully understood. OBJECTIVES: This study aimed to determine the clinical, radiological and pathological characteristics of patients with OP presenting a solitary nodular shadow on a chest radiograph. METHODS: Fourteen patients who presented with a solitary nodular shadow on a chest radiograph, pathologically diagnosed as OP after surgical resection, were allocated into two groups according to the histological findings. The first had OP with aggregates of neutrophils in airways and/or pulmonary parenchyma with or without necrosis or destruction of lung architecture (group 1: OP with neutrophilic infiltration; n = 10). The second consisted of patients with OP presenting neither neutrophilic infiltration, necrosis nor destruction of lung architecture (group 2: OP without neutrophilic infiltration; n = 4). RESULTS: Cough, sputum, and chest pain were the common symptoms in both groups of patients. Computed tomography (CT) revealed that all nodules in both groups were located in the peripheral lung parenchyma and had irregular margins, and their shapes varied from round to wedge-shaped. Haemophilus influenzae was isolated from sputum or transbronchial aspirates from 3 patients in group 1. CONCLUSIONS: The specimens resected from patients with focal OP mostly show small aggregates of neutrophils. However, the dominant histological feature is OP and neutrophilic infiltration, suggesting infection was a minor histological component in all cases. Clinical symptoms and chest CT findings did not clearly distinguish these two groups of patients. It is thus reasonable to place these OPs in the same category and to treat them in the same way. Surgical excision appears to be the only method for a precise diagnosis.


Assuntos
Pneumonia em Organização Criptogênica/diagnóstico por imagem , Pneumonia em Organização Criptogênica/imunologia , Pneumonia em Organização Criptogênica/microbiologia , Pneumonia em Organização Criptogênica/patologia , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Infiltração de Neutrófilos , Estudos Retrospectivos , Escarro/microbiologia , Tomografia Computadorizada por Raios X
15.
Respiration ; 66(3): 266-8, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10364745

RESUMO

Bronchiolitis obliterans organizing pneumonia (BOOP) is an uncommon pulmonary disorder, the clinical spectrum of which is variable. We present a fatal case of BOOP, which developed spontaneous pneumothorax, a complication considered rare. Unusual was also the upper lobe distribution of the infiltrates. The histologically diagnosed disease failed to respond to antibiotics and corticosteroids and the 74-year-old patient eventually succumbed with acute respiratory distress syndrome, 50 days after disease onset. Spontaneous pneumothorax should be added to the complications of BOOP, which may adversely affect prognosis.


Assuntos
Pneumonia em Organização Criptogênica/complicações , Pneumotórax/etiologia , Idoso , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Pneumonia em Organização Criptogênica/microbiologia , Evolução Fatal , Humanos , Legionella pneumophila/isolamento & purificação , Pneumotórax/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X
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