Chonnam Med J.  2002 Jun;38(2):170-174.

A Case of Pulmonary Tuberculosis Following Bronchiolitis Obliterans with Organizing Pneumonia (BOOP)

• Kim YC
• Jang AS
• Kim JS
• Oh SH
• Lee YY
• Son JG
• Sun HJ
• Lee JS

Abstract

As the infectious causes of bronchiolitis, Mycoplasma pneumoniae, respiratory syncytial virus, and a number of other viruses and bacterial agents have been identified. But pulmonary tuberculosis have not been reported as an etiologic factor of bronchiolitis obliterans with organizing pneumonia(BOOP). We experienced pulmonary tuberculosis presenting as BOOP. A 44-year-old man was admitted to our hospital because of nonproductive cough and dyspnea on exertion. Chest X-ray revealed bilateral irregular patchy opacities in lower lung fields. Because of the respiratory impairment broad-spectrum antibiotics treatment was commenced at once. As the response was poor, high-resolution CT (HRCT) and transbronchial lung biopsy (TBLB) was performed. HRCT findings revealed patchy air-space consolidation, ground-glass opacities, and bronchial wall thickening. TBLB specimens revealed thickened alveolar septal walls composed of fibrosis and inflammatory cells, hyperplastic alveolar lining cells, and collection of foamy histiocytes in alveolar lumen. and the lesion on these findings he was diagnosed as having BOOP. Treatment with initially 60 mg prednisolone daily quickly brought about improvement. During prednisolone tapering, sputum examination revealed positive AFB stain. Anti-tuberculosis medication was done. Follow up chest X-ray clearly revealed resolution of many patchy consolidations in both lung fields.

Keyword

BOOP; Pulmonary tuberculosis

MeSH Terms

Adult
Anti-Bacterial Agents
Biopsy
Bronchiolitis Obliterans*
Bronchiolitis*
Cough
Cryptogenic Organizing Pneumonia
Dyspnea
Fibrosis
Follow-Up Studies
Histiocytes
Humans
Lung
Mycoplasma pneumoniae
Pneumonia*
Pneumonia, Mycoplasma
Prednisolone
Respiratory Syncytial Viruses
Sputum
Thorax
Tuberculosis, Pulmonary*
Anti-Bacterial Agents
Prednisolone