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Cryptogenic organising pneumonia: an unusual cause of pleuritic chest pain
  1. Rebecca Ceci Bonello1,
  2. Etienne Ceci Bonello1,
  3. Christian Vassallo2 and
  4. Edward Giles Bellia3
  1. 1Medicine, Mater Dei Hospital, L-Imsida, Malta
  2. 2Rheumatology, Mater Dei Hospital, Msida, Malta
  3. 3Department of Geriatrics, Rehabilitation Hospital Karin Grech, Pieta, Malta
  1. Correspondence to Dr Etienne Ceci Bonello; etienne.ceci{at}gov.mt

Abstract

A 76-year-old woman presented with a 2-hour history of pleuritic chest pain with no other associated symptoms. Blood investigations revealed raised inflammatory markers and an elevated white cell count. On chest radiograph, an airspace shadow indicative of a consolidation was prominent. This was followed by a CT scan of her thorax which showed a spiculated lesion in the right upper lobe, a lesion in the posterior segment of the left lower lobe and mildly enlarged right hilar lymph nodes. She was started on dual antibiotic therapy; however, the patient’s clinical status and inflammatory markers did not improve. A bronchoscopy was performed which excluded malignancy and atypical pathogens. CT-guided biopsy confirmed the presence of cryptogenic organising pneumonia. Prednisolone 50 mg daily was prescribed with quick resolution of symptoms.

  • respiratory medicine
  • interstitial lung disease
  • pneumonia (respiratory medicine)
  • radiology

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Footnotes

  • Contributors RC; manuscript preparation and imaging editing. ECB; imaging preparation, manuscript editing and discussion. CV; manuscript editing and discussion. EB; guarantor of case integrity.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.