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Case Reports
. 2022 Sep;162(3):e111-e116.
doi: 10.1016/j.chest.2022.03.052.

A Man With Malaise, Myalgia, and Rapidly Progressive Interstitial Lung Disease

Marissa O'Callaghan  1 , Leah Rooney  2 , Jehangir Khan  3 , Sinead Flanagan  4 , Michael P Keane  1 , Aurelie Fabre  4 , Lorraine O'Neill  2 , Cormac McCarthy  5
Affiliations
Case Reports

A Man With Malaise, Myalgia, and Rapidly Progressive Interstitial Lung Disease

Marissa O'Callaghan et al. Chest. 2022 Sep.

Abstract

A 45-year-old man sought treatment at the ED during the third wave of the COVID-19 pandemic with a month-long history of fatigue, cough, myalgia, and hand stiffness. He did not report dyspnea. He had no past medical history and previously was fit and active, working as a farmer. He was a lifelong nonsmoker and had no family history of lung disease.

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Figures

Figure 1
Figure 1
Posterior anterior chest radiograph demonstrating diffuse alveolar infiltrates bilaterally.
Figure 2
Figure 2
A-D, CT pulmonary angiograms demonstrating diffuse bilateral ground-glass change with reticular nodular opacities opacification in the lower lobes: coronal image (A) and axial slices from lung apices to bases (B-D).
Figure 3
Figure 3
A-C, Photographs showing hyperkeratosis and skin cracking (A, B) and periungual erythema and dilated nail-fold capillaries (C).
Figure 4
Figure 4
A-C, Axial slices from a chest CT scan demonstrating progression of bilateral lower lobe consolidation and bilateral pneumothoraces with extensive subcutaneous emphysema throughout the superficial soft tissues of the chest extending into the mediastinum.
Figure 5
Figure 5
A-C, Photomicrographs of video-assisted thoracoscopic surgery lung biopsy samples showing: (A) cystically dilated subpleural alveoli and rigid-appearing alveolar walls (×125 magnification; scale bar, 1,000 μm), (B) diffuse regular interstitial expansion of alveolar walls by fibrosis consistent with a nonspecific interstitial pneumonia pattern (×100 magnification; scale bar, 100 μm), and (C) focal organizing pneumonia with endoalveolar buds (blue arrows) also present (×100 magnification; scale bar, 100 μm).
See this image and copyright information in PMC

References

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