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Cryptogenic organising pneumonia — SCE Respiratory MCQ

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ModerateILDCryptogenic organising pneumoniaSCE Respiratory

A 55-year-old woman has 6 weeks of cough, fever and weight loss despite two antibiotic courses. CT shows bilateral peripheral patchy consolidation with small areas migrating compared with a film from 3 weeks earlier. Bronchoscopy cultures are negative and transbronchial biopsy suggests organising pneumonia. What is the most appropriate management?

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Correct answer: C — Start oral corticosteroid therapy with follow-up imaging

Migratory peripheral consolidation with negative cultures and compatible histology supports organising pneumonia, for which corticosteroids are usually effective when symptomatic. Empirical TB treatment is inappropriate without microbiological or clinical support. Pleurodesis, inhaled colistin and lobectomy do not match the diffuse inflammatory pattern.

Reference: BTS ILD Guidance; ERS Statement on Organising Pneumonia