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Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity


Mohammad, Nurashikin and Che Rahim, Mohd Jazman and Wan Ahmed, Wan Aireene and Wan Ghazali, Wan Syamimee (2021) Severe pulmonary tuberculosis with organizing pneumonia: a diagnostic ambiguity. Malaysian Journal of Medicine and Health Sciences, 17 (2). 311 - 313. ISSN 1675-8544; ESSN: 2636-9346


Pulmonary TB may present insidiously and ambiguously, leaving clinicians with a diagnostic dilemma. A 30-year-old lady with underlying spinocerebellar ataxia presented with progressive shortness of breath, prolonged cough with whitish sputum, loss of appetite and weight loss of 1-year duration. Physical examination showed a cachectic, tachypnoeic female with finger clubbing and coarse crepitations on lung auscultation. Chest radiograph showed bilateral air space opacities relatively sparing the upper zone. Contrast-enhanced CT thorax revealed bilateral cavitary necrotising consolidations, multiple scattered lung nodules with surrounding ground-glass opacities. After exclusion of alternative diagnoses, cryptogenic organizing pneumonia diagnosis was made. She had a rapid clinic improvement once steroid was started. TB polymerase chain reaction (PCR) from bronchoscopic bronchial washing eventually was positive. Anti-TB treatment was started, and oral steroid was slowly tapered down. Organizing pneumonia (OP) may complicate pulmonary TB. Diagnosing OP without lung biopsy requires a multi-disciplinary approach, taking into consideration all available evidences. Early steroid therapy is lifesaving and should be considered after thorough exclusion of alternative diseases.

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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
Publisher: Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia
Keywords: Pulmonary tuberculosis; Pulmonary TB; Organizing pneumonia
Depositing User: Ms. Che Wa Zakaria
Date Deposited: 06 Mar 2023 04:23
Last Modified: 06 Mar 2023 04:23
URI: http://psasir.upm.edu.my/id/eprint/95056
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