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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
"showing a cryptogenic organizing pneumonia"
symptom
legionellosis
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