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CASE REPORT
Acute fibrinous organising pneumonia: a manifestation of trimethoprim-sulfamethoxazole pulmonary toxicity
  1. Fady Jamous1,
  2. Syed Zain Ayaz2,
  3. Jacquelyn Choate3
  1. 1Department of Pulmonary & Sleep Medicine, Avera Medical Group, Sioux Falls, South Dakota, USA
  2. 2Department of Internal Medicine, University of South Dakota, Sioux Falls, South Dakota, USA
  3. 3Department of Physicians Laboratory, Avera McKennan Hospital, Sioux Falls, South Dakota, USA
  1. Correspondence to Dr Fady Jamous, fady.jamous{at}avera.org

Summary

A 50-year-old man was treated with trimethoprim-sulfamethoxazole (TMP-SMX) for acute arthritis of his right big toe. Within a few days, he developed dyspnoea, hypoxaemia and diffuse pulmonary infiltrates. Symptoms improved with discontinuation of the antibiotic but worsened again with its reintroduction. An open lung biopsy was performed. We describe the workup performed and the factors that pointed to a final diagnosis of TMP-SMX-related pulmonary toxicity in the form of acute fibrinous organising pneumonia.

https://doi.org/10.1136/bcr-2014-205017

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