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Fatal pulmonary cavitary disease secondary to in a patient with sarcoidosis. | LitMetric

Fatal pulmonary cavitary disease secondary to in a patient with sarcoidosis.

J Community Hosp Intern Med Perspect

Pulmonary and Critical Care Department, Interfaith Medical Center, Brooklyn, NY, USA.

Published: December 2017

AI Article Synopsis

  • - A 62-year-old female with a history of sarcoidosis and hypertension developed cough, fever, and dyspnea, resulting in a diagnosis of cavitary lung infection after her sputum tested positive for acid-fast bacilli (AFB).
  • - She was initially treated with multiple antibiotics and showed improvement, but was readmitted ten months later with severe complications from pneumonia and worsening lung lesions.
  • - Despite aggressive treatment, including intravenous antibiotics and continued anti-tubercular therapy, her condition deteriorated rapidly, leading to respiratory failure and death, highlighting the need for better treatment guidelines for rare infections like those caused by M. xenopi.

Article Abstract

: () has low pathogenicity and usually requires either host immune impairment or structural lung disease to cause clinical disease. Fatal cavitary infection in a patient without immunosuppression is rarely presented. : A 62-year-old female with history of sarcoidosis and hypertension presented with cough, fever and dyspnea for one week. Chest imaging showed irregular opacification of upper lung zones. The sputum samples tested positive for acid-fast bacilli (AFB) and the subsequent testing identified . She was started on rifampin, isoniazid, pyrazinamide and ethambutol along with azithromycin, and was discharged with plans to continue the same. A follow up sputum test was negative for AFB. She was, however, readmitted ten months later with sepsis due to pneumonia. Chest imaging revealed worsening cavitary lung lesions. Despite starting her on intravenous antibiotics while continuing anti-tubercular therapy, she developed severe respiratory distress and had to be intubated. Her condition continued to deteriorate and she expired the following day. Fatal cavitary infections with M. xenopi have been reported in the absence of established optimal management. Well-designed studies with sufficient power are needed to establish new treatment guidelines.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738639PMC
http://dx.doi.org/10.1080/20009666.2017.1407211DOI Listing

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