A 58-year-old woman treated 6 weeks ago for community acquired pneumonia returns with persistent dry cough and breathlessness. Repeat imaging shows bilateral peripheral patchy consolidation that has migrated to new zones despite two antibiotic courses. Biopsy shows plugs of loose connective tissue filling alveolar ducts and bronchioles. Which treatment is expected to produce clinical response?

• A Addition of a macrolide to the current regimen
• B Empirical antifungal therapy
• C Bronchodilators alone
• D Corticosteroid therapy leading to rapid improvement ✓

Explanation

Organizing pneumonia, whether cryptogenic or secondary, shows Masson bodies, polypoid plugs of granulation tissue within alveolar ducts and bronchioles, with preservation of lung architecture. Clinically it mimics unresolved infection with migratory peripheral consolidation. It responds promptly to corticosteroids, though relapse is common on withdrawal. Failure of appropriate antibiotics excludes bacterial pneumonia as the ongoing process.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.