Scivoletti-Polan NA, Valentino DJ, Rosenberg SB, Cowan SW, Soiferman EI. A 65-Year-Old Man With Shortness of Breath, Pleuritic Chest Pain, and Recurrent Pneumonia. J Am Osteopath Assoc 2010;110(12):733-736. doi: 10.7556/jaoa.2010.110.12.733.
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Recurrent pulmonary infections are common among patients with chronic obstructive pulmonary disease. Imaging of the thorax beyond a routine chest radiograph, such as computed tomography imaging, should be considered for these patients. Fiberoptic bronchoscopy should also be considered for these patients, especially in cases in which respiratory cultures do not provide guidance for antibiotic therapy. The patient in the present case report experienced recurrent pneumonias despite adequate treatment with intravenous and oral antibiotics. He underwent computed tomography imaging of the thorax, which demonstrated a suspicious lesion in the left mainstem bronchus. This finding prompted a fiberoptic bronchoscopy, which revealed an endobronchial tumor. Given the patient's history of cigarette smoking, it was surprising to find that he had a benign endobronchial neurogenic tumor, which was removed in subsequent rigid bronchoscopy.
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