CTICasesAcute Exacerbation of Idiopathic Pulmonary Fibrosis Triggered by Minor Trauma
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Imaging findings
High-resolution CT shows a background pattern of idiopathic pulmonary fibrosis consistent with a usual interstitial pneumonia pattern, characterized by subpleural, basilar-predominant honeycombing, traction bronchiectasis, and architectural distortion. Superimposed on this chronic pattern is new, extensive, bilateral ground-glass opacity, particularly prominent in the upper lobes away from the areas of dense fibrosis.
Key takeaways
Acute exacerbation of interstitial lung disease is defined by the rapid onset of progressive dyspnea and new bilateral ground-glass opacities or consolidation superimposed on a background of chronic fibrosis. In patients with a persistent pulmonary inflammatory state, even minor physical insults or trauma (such as a minor fall, biopsy, or surgery) can trigger a life-threatening acute exacerbation. Treatment typically involves high-dose corticosteroids once active infection has been excluded.
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