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Delayed organising pneumonia in an immunocompromised host after a mild COVID-19 infection
  1. Han Wei Tiew1,
  2. Joanne Wei Ping Tan1 and
  3. Clarence Hai Yi Teo2
  1. 1General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
  2. 2Pathology, Tan Tock Seng Hospital, Singapore, Singapore
  1. Correspondence to Dr Han Wei Tiew; tiewhw{at}gmail.com

Abstract

Organising pneumonia after a mild COVID-19 infection has been increasingly reported and poses a diagnostic challenge to physicians especially in immunocompromised patients. We report a patient with a background of lymphoma in remission on rituximab who presented with prolonged and persistent fever after recovering from a mild COVID-19 infection. The initial workup showed bilateral lower zone lung consolidation; however, the infective and autoimmune workup were unremarkable. Subsequently, a bronchoscopy with transbronchial lung biopsy confirmed the diagnosis of organising pneumonia. A tapering glucocorticoid regimen was commenced with prompt resolution of the patient’s clinical symptoms, and subsequent resolution of biochemical markers and radiological lung changes 3 months later. This case highlights the importance of early recognition of the diagnosis of organising pneumonia in immunocompromised populations after a mild COVID-19 infection as it shows promising response to glucocorticoid therapy.

  • COVID-19
  • Respiratory medicine

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Footnotes

  • Contributors HWT discussed the case presentation, investigations and management of the patient with JWPT and CHYT. HWT wrote the case under continuous supervision of JWPT.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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