Research Day
SECONDARY ORGANIZING PNEUMONIA IN A 5-YEAR-OLD PATIENT WITH DOWN SYNDROME AND T CELL DEFICIENCY
Document Type
Abstract
Date
2021
Abstract
Post-infectious (secondary) organizing pneumonia (OP) is a rare phenomenon with nonspecific clinical findings, and variable radiographic patterns. In this abstract, we describe a case of post-infectious organizing pneumonia secondary to rhino/enterovirus infection in a 5-year-old Down syndrome (DS) female patient with T cell Immune deficiency and chronic pulmonary aspiration. Our patient is a 5-year-old female with DS and chronic pulmonary aspiration. She presented with shortness of breath and was found to have Rhino/enterovirus. A chest X-Ray (CXR) discovered bibasilar pulmonary opacities, suspicious for a community acquired pneumonia. She was started on amoxicillin and discharged in a stable condition. Three days later, patient was readmitted due to hypoxia in the clinic. A repeat CXR showed a secondary organizing pneumonia. A computed tomography of the chest found bilateral patchy ground-glass opacification lesions. Patient improved with an oral steroid. The classic radiologic features of OP are focal consolidation and ground glass opacities. The histologic pattern is defined by the presence of buds of granulation tissue. Biopsy is the gold standard for confirmation, but not required.Our patient's radiographic findings were consistent with post-infectious OP and her improvement with corticosteroid persuaded against a biopsy. In addition, DS patients have high rates of infections in the respiratory tract, attributed to their defective immune systems. In our patient, immunologic workup revealed low total lymphocyte count (CD45+) and T lymphocytes (CD3 and CD4). In this report, we highlight a rare pediatric case of post-infectious OP and a possible contributory role of immune dysregulation and chronic pulmonary aspiration.