Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity
Pulmonary TB may present insidiously and ambiguously, leaving clinicians with a diagnostic dilemma. A 30-year-old lady with underlying spinocerebellar ataxia presented with progressive shortness of breath, prolonged cough with whitish sputum, loss of appetite and weight loss of 1-year duration. Phys...
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| Format: | Article |
| Language: | English |
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Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia
2021
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| Online Access: | http://psasir.upm.edu.my/id/eprint/95056/1/2021040613571647_MJMHS_0589.pdf |
| _version_ | 1825937508329848832 |
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| author | Mohammad, Nurashikin Che Rahim, Mohd Jazman Wan Ahmed, Wan Aireene Wan Ghazali, Wan Syamimee |
| author_facet | Mohammad, Nurashikin Che Rahim, Mohd Jazman Wan Ahmed, Wan Aireene Wan Ghazali, Wan Syamimee |
| author_sort | Mohammad, Nurashikin |
| collection | UPM |
| description | Pulmonary TB may present insidiously and ambiguously, leaving clinicians with a diagnostic dilemma. A 30-year-old lady with underlying spinocerebellar ataxia presented with progressive shortness of breath, prolonged cough with whitish sputum, loss of appetite and weight loss of 1-year duration. Physical examination showed a cachectic, tachypnoeic female with finger clubbing and coarse crepitations on lung auscultation. Chest radiograph showed bilateral air space opacities relatively sparing the upper zone. Contrast-enhanced CT thorax revealed bilateral cavitary necrotising consolidations, multiple scattered lung nodules with surrounding ground-glass opacities. After exclusion of alternative diagnoses, cryptogenic organizing pneumonia diagnosis was made. She had a rapid clinic improvement once steroid was started. TB polymerase chain reaction (PCR) from bronchoscopic bronchial washing eventually was positive. Anti-TB treatment was started, and oral steroid was slowly tapered down. Organizing pneumonia (OP) may complicate pulmonary TB. Diagnosing OP without lung biopsy requires a multi-disciplinary approach, taking into consideration all available evidences. Early steroid therapy is lifesaving and should be considered after thorough exclusion of alternative diseases. |
| first_indexed | 2024-03-06T11:00:34Z |
| format | Article |
| id | upm.eprints-95056 |
| institution | Universiti Putra Malaysia |
| language | English |
| last_indexed | 2024-03-06T11:00:34Z |
| publishDate | 2021 |
| publisher | Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia |
| record_format | dspace |
| spelling | upm.eprints-950562023-03-06T04:23:59Z http://psasir.upm.edu.my/id/eprint/95056/ Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity Mohammad, Nurashikin Che Rahim, Mohd Jazman Wan Ahmed, Wan Aireene Wan Ghazali, Wan Syamimee Pulmonary TB may present insidiously and ambiguously, leaving clinicians with a diagnostic dilemma. A 30-year-old lady with underlying spinocerebellar ataxia presented with progressive shortness of breath, prolonged cough with whitish sputum, loss of appetite and weight loss of 1-year duration. Physical examination showed a cachectic, tachypnoeic female with finger clubbing and coarse crepitations on lung auscultation. Chest radiograph showed bilateral air space opacities relatively sparing the upper zone. Contrast-enhanced CT thorax revealed bilateral cavitary necrotising consolidations, multiple scattered lung nodules with surrounding ground-glass opacities. After exclusion of alternative diagnoses, cryptogenic organizing pneumonia diagnosis was made. She had a rapid clinic improvement once steroid was started. TB polymerase chain reaction (PCR) from bronchoscopic bronchial washing eventually was positive. Anti-TB treatment was started, and oral steroid was slowly tapered down. Organizing pneumonia (OP) may complicate pulmonary TB. Diagnosing OP without lung biopsy requires a multi-disciplinary approach, taking into consideration all available evidences. Early steroid therapy is lifesaving and should be considered after thorough exclusion of alternative diseases. Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia 2021 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/95056/1/2021040613571647_MJMHS_0589.pdf Mohammad, Nurashikin and Che Rahim, Mohd Jazman and Wan Ahmed, Wan Aireene and Wan Ghazali, Wan Syamimee (2021) Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity. Malaysian Journal of Medicine and Health Sciences, 17 (2). 311 - 313. ISSN 1675-8544; ESSN: 2636-9346 https://medic.upm.edu.my/jurnal_kami/volume_17_2021/mjmhs_vol_17_no_2_april_2021-61108 |
| spellingShingle | Mohammad, Nurashikin Che Rahim, Mohd Jazman Wan Ahmed, Wan Aireene Wan Ghazali, Wan Syamimee Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity |
| title | Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity |
| title_full | Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity |
| title_fullStr | Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity |
| title_full_unstemmed | Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity |
| title_short | Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity |
| title_sort | severe pulmonary tuberculosis with organizing pneumonia a diagnostic ambiguity |
| url | http://psasir.upm.edu.my/id/eprint/95056/1/2021040613571647_MJMHS_0589.pdf |
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