Bronchiolitis Obliterans Organizing Pneumonia in a Patient with AIDS

A 35-year-old homosexual man who had a remote history of cocaine abuse presented to the hospital with fever, chills, drenching night sweats, and progressive dyspnea of 3 months' duration. His condition had been diagnosed as AIDS 1 1/2 years before presentation. Multiple blood cultures and serol...

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Bibliographic Details
Published in:Clinical infectious diseases 1994-06, Vol.18 (6), p.921-924
Main Authors: Leo, Yee-Sin, Pitchon, Howard E., Messler, Gail, Meyer, Richard D.
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Acquired Immunodeficiency Syndrome - pathology
Adrenal Cortex Hormones - therapeutic use
Adult
AIDS
AIDS/HIV
Biological and medical sciences
Biopsies
Biopsy
Bronchiolitis Obliterans - drug therapy
Bronchiolitis Obliterans - etiology
Bronchiolitis Obliterans - pathology
Clinical Infectious Disease Articles
Corticosteroids
Cryptogenic organizing pneumonia
Dyspnea
Fever
HIV
human immunodeficiency virus
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Lung - pathology
Lungs
Male
Medical sciences
Mycobacterium avium
Opacity
Pneumocystis carinii
Pneumonia - drug therapy
Pneumonia - etiology
Pneumonia - pathology
Pulmonary alveoli
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Summary:A 35-year-old homosexual man who had a remote history of cocaine abuse presented to the hospital with fever, chills, drenching night sweats, and progressive dyspnea of 3 months' duration. His condition had been diagnosed as AIDS 1 1/2 years before presentation. Multiple blood cultures and serological tests failed to yield an infective etiology. Bronchoscopy with transbronchial biopsy, both performed twice, also failed to reveal an etiology. Empirical treatment for infection with the Mycobacterium avium complex yielded no response; empirical treatment, based on abnormalities revealed by gallium scanning, for Pneumocystis carinii pneumonia led to some clinical improvement. Because of rapid respiratory deterioration at the end of this treatment course, a thoracoscopic lung biopsy was performed; this procedure demonstrated classic bronchiolitis obliterans organizing pneumonia. Corticosteroid therapy resulted in a rapid salutary response. It is important to aggressively pursue a definitive diagnosis for selected patients with a nonidentifiable infectious cause so that patients receive the correct treatment.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/18.6.921