Unusual cause of bronchiolitis obliterans in an immunosuppressed patient

Bronchiolitis obliterans organizing pneumonia (BOOP) is a diffuse interstitial lung disease, currently classified as cryptogenic organizing pneumonia (COP) when idiopathic, respectively organizing pneumonia (OP) in case of a specified etiology.

We present the case of a 48-year-old patient, former smoker (20PY), diabetic, who accused moderate dyspnea, persistent febrile syndrome. The chest radiography showed multiple areas of condensation distributed bilaterally diffusely and the laboratory data revealed an important inflammatory syndrome. More than 100 colonies of Candida albicans were isolated from the sputum, therefore antifungal therapy was initiated. The computer tomography scan (CT scan) highlighted multiple micronodular and nodular lesions, some with tendency of excavation and hydroaeric level present and a polyseptate lesion in the right lower lobe; no proliferative elements were found during bronchoscopy and the bronchoalveolar lavage was non-specific; To obtain a final diagnosis, a CT-guided transthoracic needle biopsy was performed and the histological examination was compatible with organized pneumonia.