Cryptogenic organising pneumonia: an unusual cause of pleuritic chest pain

• Published in: BMJ case reports Vol. 14; no. 1; p. e238514
• Main Authors: Ceci Bonello, Rebecca, Ceci Bonello, Etienne, Vassallo, Christian, Bellia, Edward Giles
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 18.01.2021; BMJ Publishing Group
• Subjects: Aged; Antibiotics; Biopsy; Case Report; Case reports; Cellular biology; Chest Pain - etiology; Coronary vessels; Cryptogenic Organizing Pneumonia - complications; Cryptogenic Organizing Pneumonia - diagnosis; Diagnosis, Differential; Dyspnea; Female; Fibroblasts; Humans; Lung diseases; Medical imaging; Neutrophils; Pain; Patients; Pleurisy - etiology; Pneumonia; Thorax; respiratory medicine; pneumonia (respiratory medicine); interstitial lung disease; radiology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-238514

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.