Secondary Organizing Pneumonia Following Influenza A in a Patient from Southern Khyber Pakhtunkhwa: A Case Report
Keywords:
Organizing Pneumonia, Influenza A, Cryptogenic Organizing Pneumonia, Dera Ismail Khan, PakistanAbstract
Influenza viruses are a frequent cause of seasonal respiratory illness and serious pulmonary complications. While both viral pneumonia and bacterial co-infection can be complications of influenza pneumonia, a rare but underrecognized complication is Secondary Organizing Pneumonia (SOP). Most cases of SOP due to influenza have been due to Influenza A. We report a case of a 56-year-old man from the Dera Ismail Khan region in Pakistan with severe influenza A pneumonia who, despite appropriate antiviral and broad-spectrum antibacterial therapy, clinically and radiologically deteriorated. A diagnosis of SOP was suspected based on characteristic imaging findings and confirmed after a workup showed there was no ongoing infection. Treatment with corticosteroids initiated, and there was rapid dramatic improvement. The case highlights the need to consider this diagnosis in patients with pneumonia who do not resolve following influenza.References
Cottin V, Cordier JF. Cryptogenic organizing pneumonia. Semin Respir Crit Care Med. 2012;33(5):462-475. DOI:10.1055/s-0032-1325157.
Drakopanagiotakis F, Paschalaki K, Abu-Hijleh M, Aswad B, Karagianidis N, Kastanakis E, et al. Cryptogenic and secondary organizing pneumonia: clinical presentation, radiographic findings, treatment response, and prognosis. Chest. 2011;139(4):893-900. DOI:10.1378/chest.10-0883.
Okahashi N, Sumitomo T, Nakata M, Kawabata S. Secondary streptococcal infection following influenza. Microbiol Immunol. 2022;66(6):253-63. DOI:10.1111/1348-0421.12965.
King Jr TE, Lee JS. Cryptogenic organizing pneumonia. N Engl J Med. 2022;386(11):1058-69. DOI: 10.1056/NEJMra2116777.
Keskin Z, Yesildag M. The evaluation of the association between the prevalence and patterns of computed tomography findings of cryptogenic organizing pneumonia, and neutrophil/lymphocyte and platelet/lymphocyte ratios. Chin J Acad Radiol. 2022;5(1):61-8. DOI: 10.1007/s42058-022-00090-w.
Guillin R, Marchand AJ, Roux A, Niederberger E, Duvauferrier R. Imaging of snapping phenomena. Br J Radiol. 2012;85(1018):1343-53. DOI:10.1259/bjr/52009417.
Li L, Zhang M, Wei Y, Tu X, Lu Z, Cheng Y. Clinical significance of procalcitonin in critically ill patients with pneumonia receiving bronchoalveolar lavage. Sarcoidosis Vasc Diffuse Lung Dis. 2022;39(3):e2022031. DOI: 10.36141/svdld.v39i3.12164.
Lansbury L, Rodrigo C, Leonardi?Bee J, Nguyen?Van?Tam J, Lim WS. Corticosteroids as adjunctive therapy in the treatment of influenza. Cochrane Database of Systematic Reviews 2019;2. DOI: 10.1002/14651858.CD010406.pub3.
Zhou Y, Fu X, Liu X, Huang C, Tian G, Ding C, et al. Use of corticosteroids in influenza-associated acute respiratory distress syndrome and severe pneumonia: a systemic review and meta-analysis. Sci Rep. 2020;10(1):3044. DOI:10.1038/s41598-020-59732-7
Gómez-Gómez A, Martínez-Martínez R, Gotway MB. Organizing pneumonia associated with swine-origin influenza A H1N1 2009 viral infection. Am J Roentgenol. 2011;196(2):W103-4. DOI:10.2214/AJR.10.4313.
He H, Wang H, Li X, Tang X, Sun B, Tong Z. Successful management of refractory respiratory failure caused by avian influenza H7N9 and secondary organizing pneumonia: a case report and literature review. BMC Infect Dis. 2019;19(1):671. DOI:10.1186/s12879-019-4306-7.
Kwok WC, Lam SH, Wong MP, Lam DC, Ip MS. Influenza B/Streptococcal co-infection complicated by organizing pneumonia. Respirol Case Rep. 2016;4(3):e00170. DOI:10.1002/rcr2.170.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Chest Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
