The aftermath of COVID-19 continues to unveil an array of pulmonary complications, extending beyond the acute phase of the viral infection. Among these emerging sequelae, we present the case of a 58-year-old individual who developed pulmonary inflammatory pseudotumors (PIPs) following recovery from COVID-19. PIPs are exceedingly rare benign lesions that can pose a diagnostic challenge due to their clinical and radiological resemblance to malignant neoplasms. Histologically, PIPs are characterized by a proliferation of myofibroblastic spindle cells accompanied by inflammatory infiltrates, including lymphocytes, plasma cells, and histiocytes. As our understanding of post-COVID-19 complications evolves, this case serves as the first exploration into the complex interplay between COVID-19 infections and the subsequent development of inflammatory pseudotumors. In this report, an investigation is performed into the clinical presentation, diagnostic challenges, and successful management of post-COVID-19 PIPs with a focus on the pivotal role of corticosteroid therapy in mitigating the inflammatory response associated with this unique post-viral entity and resolution of the masses.
A 57-year-old man who had recurrent respiratory infections due to tobacco use and severe chronic obstructive pulmonary disease (COPD) was evaluated as an outpatient to discern the etiology. He was followed with a chest X-ray and a chest computed tomography (CT) scan that displayed a left upper lobe cavitary lung abnormality. The lesion was further evaluated with a CT-guided biopsy, and it was identified as a lung abscess. A tissue culture isolated Propionibacterium acnes. We present a rare case of a common skin commensal, P. acnes, that infected the left upper lobe of the lung. We presume that the patient was predisposed to infection secondary to degradation of pulmonary parenchyma by severe bullous emphysema. This destruction created an inflammatory and colonizing space for organisms, even uncommon forms, to flourish. Initially this presentation prompted a differential of pulmonary tuberculosis; however, with further workup, the diagnosis was excluded. This case highlights the potential of P. acnes, an uncommon lung microbe, to lead to a lung abscess in a patient who was otherwise immunocompetent. This case will allow osteopathic clinicians to detect an uncommon microorganism that can potentially cause a pulmonary abscess in a patient with a medical history of severe bullous emphysematous COPD.
Emphysema , Lung Abscess , Pulmonary Disease, Chronic Obstructive , Pulmonary Emphysema , Emphysema/diagnosis , Emphysema/diagnostic imaging , Humans , Lung Abscess/diagnosis , Lung Abscess/diagnostic imaging , Male , Middle Aged , Propionibacterium acnes , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/pathology
Nosotros tratamos 29 pacientes en fase crónica o acelerada de Leucemia mieloide crónica (LCM) con alfa interferón en una dosis de 2 millones de unidades por metro cuadrado de superficie corporal subcutaneamente, diario por 30 días, luego 3 veces por semana. La mayoría habían recibido tratamiento anteriormente. Tres pacientes alcanzaron remisión hematológica y cariotípica completa sostenida después de un tratamiento medio de 22 meses, otros tres pacientes alcanzaron remisión hematológica completa y remisión cariotípica incompleta. Para un seguimiento medio de 48 meses, la sobrevivencia media no ha sido alcanzada. Esta dosis de interferón puede inducir remisiones duraderas aún en pacientes que han recibido tratamiento y podría prolongar la sobrevivencia en LMC
Adult , Middle Aged , Humans , Female , History, 20th Century , Interferon-alpha/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy , Honduras
