Diagnosis And Treatment Of Cases Of Cryptogenic Organic Pneumonia Resembling Community Acquired Pneumonia

Objective: To explore the early diagnosis and treatment of cryptogenic organic pneumonia with clinical symptoms,laboratory examinations and imaging manifestations similar to community acquired pneumonia,and accumulate the experience of diagnosis and treatment of cryptogenic organic pneumonia,so as to provide evidence-based reference for the early diagnosis and treatment of patients who have unconditionally completed pathological biopsy.Methods: The clinical data of 28 patients with cryptogenic organic pneumonia whose clinical manifestations,laboratory examinations and chest CT findings were similar to those of community acquired pneumonia were retrospectively analyzed,and compared with 112 patients with community acquired pneumonia in the same period.Results: There were significant differences in fever,expectoration and dyspnea between the two groups(P < 0.05),while there were no significant differences in other symptoms(cough,chest pain,hemoptysis)(P > 0.05).There was no significant difference in blood routine,C-reactive protein,erythrocyte sedimentation rate and procalcitonin among laboratory test results(P > 0.05).Thoracic CT manifestations were mainly consolidation,ground glass nodule and mass,and some of them involved pleural and mediastinal lymph nodes.There was significant difference between the two groups in imaging with pleural effusion and mediastinal lymph node enlargement(P < 0.05).There were significant differences in the improvement of main symptoms after 72 hours of empirical antibiotic treatment(P < 0.05).Of 25 patients with organic pneumonia treated with glucocorticoid,23 were discharged from hospital with an effective rate of 92.0%.The median cumulative dose of methylprednisolone was 700 mg,and the median length of stay was 18 days.Conclusion:It is difficult to differentiate cryptogenic organic pneumonia from community acquired pneumonia in the early stage.When patients with suspected community acquired pneumonia have dyspnea,imaging with pleural effusion andmediastinal lymph node enlargement,and the main symptoms do not improve after72 hours of empirical anti-infective treatment,the possibility of organic pneumonia should be considered.