Lymphocytic interstitial pneumonitis with infective exacerbation of bronchiectasis
Presentation
Wheeze with infective symptoms ? LRTI. Previous CT suggests bronchiectasis. Known Sjogren syndrome.
Patient Data
Right mid zone thin walled cystic lesion.
Bilateral mid to lower zone airspace opacities.
Follow-up CT chest requested by the respiratory team to assess for bronchiectasis, demonstrates bronchiectasis with plugging and surrounding ground glass opacification, indicative of infective exacerbation, on a background of multiple, thin walled cysts scattered throughout the lung. Further interrogation of the patient's previous medical history revealed a previous diagnosis of Sjogren syndrome.
Case Discussion
Scattered thin walled cysts of varying sizes is a typical appearance for lymphocytic interstitial pneumonitis (LIP) in a patient with known Sjogren syndrome. In the setting of treatment with immunosuppressive therapy, the development of bronchiectasis with accompanying ground glass opacities raises the possibility of infection with atypical organisms, such as fungi or mycobacteria.