COP

Q: 64-year-old female is admitted to ICU with cough, shortness of breath, fever, and septic like picture.  CT scan of the chest done in ED ruled out any underlying pulmonary embolism but showed concern for cryptogenic organizing pneumonia (COP). Which of the following is the least likely symptom of COP?

A) Nonproductive cough 
B) Dyspnea 
C) Malaise 
D) Weight loss 
E) Hemoptysis


Answer: E 

Presentation of COP is sometimes similar to community-acquired pneumonia (CAP) with a short duration of symptoms of few weeks only. And, the only clue for the diagnosis of COP is a lack of response to empiric antibiotics! 

The classic presentation is of a patient in the fifth or sixth decade of life with persistent nonproductive cough, dyspnea, fever, malaise, and weight loss of greater than 10 pounds. Hemoptysis is rarely present in COP.

#pulmonary


References:

1. Cordier JF. Cryptogenic organising pneumonia. Eur Respir J 2006; 28:422.


2. Zhou Y, Wang L, Huang M, et al. A long-term retrospective study of patients with biopsy-proven cryptogenic organizing pneumonia. Chron Respir Dis 2019; 16:1479973119853829.