Abstract
A 63-year-old man was admitted complaining of fever and dyspnea. A chest X-ray film showed bilateral diffuse abnormal shadows and he had severe hypoxemia. Severe pneumonia was diagnosed and was treated with FMOX, DOXY, EM and FLCZ. Because the diffuse shadow worsened, a fiberoptic bronchoscopy was performed. BAL fluid findings showed an increased number of eosinophils. Examination of the TBLB specimen disclosed diffuse alveolar damage with organization. Steroid pulse therapy was effective, the pulmonary symptoms improved markedly and the chest X-ray abnormalities disappeared. Serological studies revealed an elevated titer of serum antibodies to influenza virus type A. In spite of steroid pulse therapy, acute interstitial pneumonia associated with unknown etiologies has a high mortality. Some patients with DAD may benefit from steroids. The present case illustrated the effectiveness of early steroid therapy.
