title: An unusual case of pneumonia.
abstract: A previously healthy 37-year-old man was admitted with a two-month history of increasing shortness of breath and high temperature. A chest X-ray demonstrated bibasal shadowing and small bilateral pleural effusions; arterial blood gases demonstrated low pO2. Despite intravenous antibiotics no significant improvement was observed. A high-resolution chest computed tomography showed diffuse ground-glass opacification with segmental and subsegmental airways opacification, indicating fine fibrosis. Subsequently, open lung biopsy showed diffuse alveolar damage and a histopathological diagnosis of acute interstitial pneumonia (Hamman-Rich syndrome) was made. Antibiotics were stopped and high intravenous doses of steroids were given with a dramatic improvement in the patient's breathing and radiographic findings. The pathophysiological mechanisms of acute interstitial pneumonia and current therapeutic options are discussed.
authors.affiliation: Department of Health Care of the Elderly, King's College Hospital, London, UK.
authors.forename: A A
authors.initials: AA
authors.lastname: Mangoni
authors.forename: S R
authors.initials: SR
authors.lastname: Desai
authors.forename: H
authors.initials: H
authors.lastname: Shaikh
authors.forename: R D
authors.initials: RD
authors.lastname: Barker
authors.forename: G J
authors.initials: GJ
authors.lastname: Mufti
authors.forename: S H D
authors.initials: SH
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone