Acute fibrinous and organizing pneumonia: one case report and literature review / 中国感染与化疗杂志

ABSTRACT

Objective To further improve the awareness of the clinical feature of acute fibrinous and organizing pneumonia (AFOP).Methods One case of AFOP treated in our department was described in details.The relevant cases were searched in Wanfang database using key words acute fibrinous and organizing pneumonia [in Chinese].Results Four reports containing 9 cases were identified from published literature.A total of 10 cases (including this one) were analyzed.The patients included 7 males and 3 females (43 to 78 years of age).Eight patients presented with cough.Chest tightness and dyspnea were reported in 8 cases,and fever in 9 cases.Velcro crackles were heard in 4 patients.Laboratory tests showed WBC increased in 2 cases,increased neutrophil count in 6 cases,elevated C-reactive protein in 9 cases,and faster erythrocyte sedimentation rate in 8 cases.The partial oxygen pressure (PO2) ranged from 54 mmHg to 69 mmHg.Chest CT scan showed unilateral lesions in 3 cases and bilateral lesions in 7 cases initially.The main CT findings were patchy,consolidation and ground-glass opacities,sometimes associated with air bronchogram.The diagnosis was confirmed by lung biopsy in all the 10 cases.Bronchoscopy biopsy was conducted in 6 cases,and percutaneous lung biopsy in 3 cases.One patient received both bronchoscopy biopsy and percutaneous lung biopsy.Methylprednisolone was used in all cases.No patient received mechanical ventilation.One patient died.Conclusions AFOP is a new type of interstitial lung disease,the etiology of which is unknown.AFOP often occurs in middle-and old-aged patients.AFOP is easily misdiagnosed due to its unspecific clinical manifestations,which are similar to common pneumonia.The confirmation of AFOP diagnosis depends on pathological biopsy.Corticosteroids treatment is appropriate,but the dosage,duration,and long term effect of corticosteroids are not established.