A 61-year-old woman was referred to our out-patient clinic for evaluation and treatment of pneumonia, which was unresponsive to antimicrobial agents. The patient was admitted for a thorough antimicrobial-resistant pneumonia examination. Subsequently, the patient’s condition rapidly declined, leading to the postponement of bronchoscopy. Treatment was initiated based on the clinical assumption of a diagnosis of organizing pneumonia. The patient survived the acute phase. Steroids were gradually tapered off on an out-patient basis. However, various symptoms appeared during the disease course, which could not be completely attributed to steroid side-effects. Therefore, multiple diagnostic tests were performed, leading to a diagnosis of neuromyelitis optica. Organizing pneumonia is a complication of various diseases. Hence, neuromyelitis optica may have been a preexisting condition. The corticosteroids used to treat the organizing pneumonia may have masked the symptoms of neuromyelitis optica, interfering with definitive diagnosis.
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