Lazarus et al reported the first case of pulmonary involvement in Sweet syndrome proven by the open lung biopsy in leukemia. Not only simple sterile pulmonary infiltration, but also several cases of bronchiolitis obliterans organizing pneumonia and acute respiratory distress syndrome have been reported in association with Sweet syndrome. Most patients treated with systemic corticosteroid therapy have yielded a good response, but the prognosis can be variable according to what the underlying disease is and whether prompt corticos- teroidal therapy was started or not.
Numerous negative culture results, lack of response to anti-microbials, histology of lung biopsies similar to skin biopsies and the prompt response to increasing doses of systemic corticosteroid therapy are strongly suggestive of pulmonary involvement in Sweet syndrome.
In our patient, investigation for infectious causes of pulmonary symptoms included sputum cultures and special staining for bacteria, fungi, and mycobacteria, all of which yielded negative results. Furthermore, despite the empiric use of antibiotics and antivirals, respiratory symptoms and concomitant pulmonary infiltrates on plain chest X-ray films were not improved, but got dramatically better after initiation of systemic corticosteroid therapy. Extensive studies to detect an underlying malignancy yielded negative results, except CA125. However, further studies were not performed because of the patient refusal. levitra professional
In summary, the identification of pulmonary processes in association with Sweet syndrome, excluding the possibility of serious infection, followed by prompt treatment with systemic corticosteroids, is an essential part of the therapeutic intervention.
We, herein, report a rare case of a 46-year-old woman with Sweet syndrome who showed pulmonary infiltration and pleural effusion upon chest X-ray.