Delayed organising pneumonia in an immunocompromised host after a mild COVID-19 infection

BMJ Case Rep. 2023 May 16;16(5):e254737. doi: 10.1136/bcr-2023-254737.

Abstract

Organising pneumonia after a mild COVID-19 infection has been increasingly reported and poses a diagnostic challenge to physicians especially in immunocompromised patients. We report a patient with a background of lymphoma in remission on rituximab who presented with prolonged and persistent fever after recovering from a mild COVID-19 infection. The initial workup showed bilateral lower zone lung consolidation; however, the infective and autoimmune workup were unremarkable. Subsequently, a bronchoscopy with transbronchial lung biopsy confirmed the diagnosis of organising pneumonia. A tapering glucocorticoid regimen was commenced with prompt resolution of the patient's clinical symptoms, and subsequent resolution of biochemical markers and radiological lung changes 3 months later. This case highlights the importance of early recognition of the diagnosis of organising pneumonia in immunocompromised populations after a mild COVID-19 infection as it shows promising response to glucocorticoid therapy.

Keywords: COVID-19; Respiratory medicine.

Publication types

  • Case Reports

MeSH terms

  • COVID-19* / pathology
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunocompromised Host
  • Lung / pathology
  • Organizing Pneumonia*
  • Pneumonia* / drug therapy

Substances

  • Glucocorticoids