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[Cryptogenic organizing non-resolving pneumonia. Report of one case].
[legionellosis]
Non-resolving
pneumonia
is
a
common
clinical
problem
that
prolongs
morbidity
and
increases
hospitalization
costs
.
We
report
an
82
year
-old
non-smoking
female
who
was
admitted
with
chronic
diarrhea
and
later
developed
nosocomial
pneumonia
.
Lung
infiltrates
did
not
resolve
despite
sequential
antibiotic
treatments
.
Infectious
causes
such
as
resistant
nosocomial
pathogens
,
respiratory
viruses
,
tuberculosis
,
Legionellosis
,
cytomegalovirus
or
agents
associated
with
HIV
infection
were
discarded
.
Non-infectious
causes
such
as
thromboembolic
lung
disease
,
neoplasms
and
rheumatic
disorders
were
also
ruled
out
.
An
exudative
pleural
effusion
was
detected
,
but
the
study
was
unremarkable
.
Fiberoptic
bronchoscopy
and
a
transbronchial
biopsy
,
revealed
nonspecific
findings
.
The
patient
persisted
febrile
,
required
non-invasive
mechanical
ventilation
and
displayed
a
migratory
pattern
of
lung
infiltrates
that
motivated
a
second
biopsy
,
this
time
by
open
thoracotomy
,
showing
a
cryptogenic
organizing
pneumonia
.
The
patient
's
conditions
improved
after
treatment
with
adrenal
steroids
.
In
patients
with
non-resolving
pneumonia
,
a
dedicated
and
comprehensive
study
should
be
done
using
invasive
procedures
and
considering
both
infectious
and
non-infectious
causes
.
Cryptogenic
organizing
pneumonia
is
one
of
the
alternatives
that
is
potentially
treatable
,
but
often
underdiagnosed
.
Diseases
Validation
Diseases presenting
"pneumonia"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
allergic bronchopulmonary aspergillosis
alpha-thalassemia
classical phenylketonuria
cohen syndrome
congenital diaphragmatic hernia
heparin-induced thrombocytopenia
hydrocephalus with stenosis of the aqueduct of sylvius
junctional epidermolysis bullosa
lamellar ichthyosis
legionellosis
liposarcoma
lymphangioleiomyomatosis
monosomy 21
oculocutaneous albinism
omenn syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
scrub typhus
severe combined immunodeficiency
triple a syndrome
waldenström macroglobulinemia
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated