Medical Case Reports

A 75-year-old African American woman presented to the Emergency Department (ED) complaining of shortness of breath, cough and a drop in her oxygen saturation (SpO2) from her baseline of 95%–88%.  She received a Pfizer COVID 19 booster vaccine one day before her symptoms began. The patient had received the Johnson & Johnson COVID-19 vaccine 11 months prior without a notable reaction.    She had a history of  chronic obstructive pulmonary disease (COPD)  but was  not on any home oxygen.  Upon admission the patient had an SpO2 of 82% and a heart rate of 101 beats per minute. Notably, she was afebrile, with a temperature of 36.6 °C. On physical exam the patient was noted to be wheezing and breathing with difficulty. She t ested negative for a variety of respiratory viruses including COVID-19.  A chest radiograph (x-ray) demonstrated subtle patchy opacifications consistent  with a COPD exacerbation, and no consolidations or pleural effusions....

Interstitial lung disease is the most common and serious complication of the inflammatory muscle diseases  It can be caused by long-term environmental exposures or autoimmune diseases such as rheumatoid arthritis, but in some cases the causes remain unknown. In a study of  545 patients with  interstitial lung disease (ILD) in Japan,  ~3% of patients  reported that COVID-19 vaccination caused an adverse reaction of worsening respiratory symptoms. F our patients experienced acute exacerbations. Two of them had collagen vascular disease-associated ILD, one had nonspecific interstitial pneumonia, another had unclassifiable idiopathic pneumonia, and none had idiopathic pulmonary fibrosis. In addition to adverse reactions, increased prevalence of non-response to vaccine was observed in patients with autoimmune-systemic-disease-related interstitial lung disease  (p = 0.009) Several other cases were described in medical literature two were so severe ...

COVID-19 vaccine-related pneumonitis (CV-P) should be considered in  patients with atypical lung infiltration, no specific etiologies, and recent  COVID-19  vaccination.  An article posted ahead of print by the Korean Journal of Internal Medicine describes 11 cases with a median age of 80. 10 individuals survived, but one patient with acute respiratory distress syndrome (ARDS), an 82-year-old-female, died despite appropriate treatment. Her chest CT displayed diffuse alveolar damage (DAD pattern).  Here are several other cases: An 83-year-old woman who received the second dose of BNT162b2-mRNA vaccine presented with an organizing pneumonia pattern of CV-P. Chest CT revealed multifocal patchy consolidations, ground-glass opacifications (GGOs), and mild interlobar septal thickening in both lungs (14 days after the second dose). BAL fluid analysis revealed neutrophils (Np) 24%, lymphocytes (Lp) 32%, eosinophils (Eo) 32%, and macrophages (Mq) 12%. All microbiolo...