JMIR Publications

ABSTRACT

Acute fibrinous and organising pneumonia (AFOP) is a rare subtype of idiopathic interstitial pneumonia, defined histologically by intra-alveolar fibrin accumulation and patchy organising fibrosis. Clinical and radiological manifestations are non-specific, frequently resulting in initial misclassification as community-acquired pneumonia; conclusive diagnosis requires histopathological examination of lung tissue. Timely diagnosis and early intervention are critical, with glucocorticoids remaining the mainstay of treatment.We describe two AFOP cases diagnosed at our centre, both of which responded favourably to glucocorticoid treatment. A systematic review of the pertinent literature was undertaken to provide further insights into the disease.Both patients initially presented with pneumonia that did not respond to antibiotics. Timely lung biopsy established the diagnosis of AFOP, and subsequent glucocorticoid therapy resulted in rapid clinical improvement.Clinicians should remain vigilant for AFOP. In patients with pneumonia unresponsive to antibiotics, early pathological assessment is essential for accurate diagnosis. Prompt initiation of appropriate therapy can substantially affect prognosis.