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A case report of acute fibrinous and organizing pneumonia
Kaige Wang1, Xinmiao Du1, Qian Wu2
1Department of Respiratory and Critical Care Medicine.
Rationale:
Acute fibrinous and organizing pneumonia (AFOP) is a newly evolving rare non-infectious lung pathology, characterized by intra-alveolar fibrin balls on histology. It is usually difficult to be diagnosed and mistaken for other lung diseases.
Patient Concerns:
In this article, an interesting case about a male patient with a 15-day history of high-grade fever, chills, and no productive cough was presented. He was misdiagnosed as the lung infection early, but exhibited no response to the antibiotic therapy.
Diagnosis:
The diagnosis of AFOP was determined by the lung biopsy and pathology.
Interventions:
With the diagnosis of AFOP, all antibiotics were discontinued, and 40 mg methylprednisolone daily was given intravenously.
Outcomes:
The patient responded well to the treatment with steroids.
Lessons:
AFOP is a rare lung disease characterized by bilateral basilar infiltrates and histological findings of organizing pneumonia and intra-alveolar fibrin in the form of "fibrin balls". Lung biopsy and histopathology were the most important diagnostic methods for the AFOP. Glucocorticoid was an effective drug for the treatment. Subacute patients of AFOP have excellent prognosis with corticosteroids.
Insights
Acute fibrinous and organizing pneumonia (AFOP) is a rare lung disease. Early diagnosis via lung biopsy and effective treatment with corticosteroids offer an excellent prognosis for patients with AFOP.
Area of Science:
- Pulmonology
- Pathology
Background:
- Acute fibrinous and organizing pneumonia (AFOP) is a rare, non-infectious lung disease.
- Histological hallmarks include intra-alveolar fibrin balls, complicating diagnosis.
- Often misdiagnosed as common lung infections.
Observation:
- A male patient presented with high-grade fever and chills for 15 days, initially treated as a lung infection.
- The patient showed no response to antibiotic therapy.
- Diagnosis was confirmed through lung biopsy and histopathology.
Findings:
- AFOP is characterized by bilateral basilar infiltrates and specific histological findings.
- Lung biopsy and histopathology are crucial for accurate AFOP diagnosis.
- Methylprednisolone (a glucocorticoid) at 40mg daily resulted in a positive patient response.
Implications:
- Glucocorticoids are effective treatments for AFOP.
- Prompt diagnosis and corticosteroid treatment lead to an excellent prognosis for subacute AFOP cases.
- Increased awareness of AFOP can improve patient outcomes by preventing misdiagnosis and delayed treatment.
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