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- 저자 : ( Vania Gomes ) (검색결과 1 건)
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Poster Session : PS 0653 ; Respiratory Medicine ; Organizing Pneumonia and Cytomegalovirus Infection
( Vania Gomes ),( Rosa Macedo Carvalho ),( Maria Joao Ferreira Da Silva ),( Ceu Rodrigues ),( Antonio Oliveira E Silva ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Organizing pneumonia is a diffuse interstitial lung disease. Secondary organizing pneumonia can be seen in association with various diseases, including infections. Cytomegalovirus (CMV) is a human herpesvirus that has as peculiar characteristic its capacity of latency. The clinical disease is rare in immunocompetents individuals. Methods: Revision of one clinical case. Results: A 54 years old male, with known diabetes mellitus, was admitted to the emergency room due to rest dyspnoea, productive cough and fever. These symptoms were preceded by the acute onset of a fi u-like illness with odynophagia, nonproductive cough, diarrheal stools and fatigue. He was discharged with empiric antibiotics and low dose prednisolone. On the seventh day, he was readmitted with persistent fever, mild hemoptysis and pleuritic bilateral chest pain. He presented hypoxemic with severe acute respiratory failure, requiring noninvasing ventilation. The chest radiograph revealed bilateral, diffuse and consolidative opacities. Different antibiotics were started. There was no microbiological isolation. As an inpatient, he improved clinically and was discharged after 17 days. After fi ve days, he was readmitted with the same clinical picture. The high resolution computerized axial tomography showed extensive bilateral disease consistent with organizing pneumonia: small nodular opacities in a subpleural location, patchy air-space consolidation and ground glass diffuse opacities. He was medicated with prednisolone 1mg/kg/day. Viral serologies were performed and revealed active acute infection with CMV. The bronchoalveolar lavage showed a predominance of lymphocytes and CMV was isolated. He began oral valciclovir and was discharged after 10 days with no symptoms. After 4 weeks, the dose of glucocorticoid was tapered, the patient remained asymptomatic and serological conversion of CMV titles was confi rmed. Conclusions: We describe a rare case of organizing pneumonia in a diabetic male who was pharmacology immunosuppressed after initial symptoms. As the patient improved, no lung biopsy was performed.
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