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Center: Day 5 after initiation of quetiapine, chest radiography showed bilateral patchy and linear opacities in roche catalog lungs. Right: After 7 days of antibiotic therapy, chest radiography showed an increase in diffuse patchy opacities in both lungs. On the 4th day of roche catalog, his neurologic and behavioral symptoms showed improvement. However, he complained of fever and coughed up sputum. His clinical pulmonary infection score was 6 points (body temperature of 38.

Chest radiography showed bilateral infiltrates in both lung fields along with left side pleural effusion (Fig. His symptoms persisted into the 7th day of hospitalization despite 2 days of antibiotic therapy.

Laboratory tests showed the following findings: hemoglobin, 11. Follow-up chest radiography showed increased diffuse patchy and linear opacities roche catalog well as pleural effusion in both lungs (Fig.

A high-resolution computed tomography scan of the chest showed bilateral pulmonary consolidations and ground-glass opacities with a predominantly peribronchial and subpleural distribution (Fig. The Legionella and pneumococcal urinary antigen tests were all negative. A rapid influenza antigen test was also negative, but polymerase roche catalog reactions for 16 respiratory viruses were not performed because of his financial limitation.

Roche catalog bronchoscopic washing specimens were all negative for Mycobacterium tuberculosis, which was determined by an roche catalog bacilli smear, polymerase chain roche catalog, and microbial culture.

High-resolution computed tomography scan of the roche catalog showed bilateral pulmonary consolidations and ground-glass opacities with a predominantly roche catalog and subpleural distribution. Based on the clinical symptoms roche catalog the low procalcitonin level, drug-induced interstitial lung disease (DILD) was suspected, and quetiapine treatment and all antibiotics roche catalog discontinued.

After 2 weeks of steroid therapy, his symptoms and radiologic findings significantly improved (Fig. The patient did not continue the recommended follow-up roche catalog. However, 2 years later, the patient returned to our hospital and complained of knee pain, and chest radiography showed complete remission with no signs of pleural effusion or bilateral infiltrates noted (Fig.

Attribution theory After discontinuation roche catalog quetiapine therapy and 14 days of steroid therapy, chest radiography showed a decreased extent of patch consolidation in both lung fields. Right: After 2 years, chest radiography showed no consolidations in either lung field. Quetiapine is an atypical antipsychotic medication effective for treating schizophrenia, bipolar disorder, and major depressive roche catalog. A small, randomized, placebo-controlled trial found significant improvement in noncognitive aspects of delirium with quetiapine.

Most importantly, to ensure accurate diagnosis, other causes of lung damage, roche catalog as infectious disease, must be excluded. There are 2 mechanisms involved in DILD that are probably interdependent: one is cytotoxic pulmonary injury, and the other is immune-mediated. Cytotoxic pulmonary injury may occur via reactive oxygen species, reduction in deactivation of metabolites roche catalog the lung, impairment of alveolar repair mechanisms, and release roche catalog various cytokines.

These include cytotoxic drugs, such as bleomycin, methotrexate, and cyclophosphamide, and noncytotoxic drugs, such as nitrofurantoin, sulfasalazine, and amiodarone.

Immune-mediated DILD may be mostly T cell-mediated. For example, in minocycline- and amiodarone-induced interstitial pneumonia, some proportion may result from an immune-mediated mechanism. The mainstay of DILD treatment is cessation of suspected drugs, but in severe cases, steroid therapy may be considered.

A pathological examination was not performed on our patient.



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