[Bronchocentric granulomatosis and mycoplasmal pneumonia].
A 61-year-old man presented with dyspnoea, chest pain, high fever and rigour. Chest X-ray revealed a combination of alveolar consolidations and abnormal nodular and interstitial markings. His clinical condition deteriorated despite treatment with antibiotics prescribed on a working diagnosis of pneumonia with an atypical pathogen. Finally, an open-lung biopsy specimen showed the characteristic picture of bronchocentric granulomatosis. Serological testing supported a primary infection with Mycoplasma pneumoniae. The patient responded well to treatment with prednisolone and erythromycin and five months after discharge, no radiological abnormalities were found. The combination of bronchocentric granulomatosis and mycoplasmal pneumonia has never been described in the literature and a causal relation can only be suggested. This case-report illustrates the importance of invasive diagnostic procedures if a patient with a clinical pneumonia fails to respond to adequate treatment.
Keijzer
A
A
Afd. Longziekten, Medisch Centrum Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar.
Daniels
J M
JM
Slieker
W A
WA
Timens
W
W
de Graaff
C S
CS
Boersma
W G
WG
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001982:Bronchial Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D004917:Erythromycin / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D015769:Granuloma, Respiratory Tract / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D004917:Erythromycin; D011239:Prednisolone