Radiographic features of persistent pneumonia and cystic bronchiectasis in bronchiectasis-copd overlap syndrome : A case report

Background

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory condition characterized by persistent airflow obstruction and respiratory symptoms that may impair breathing. Bronchiectasis-COPD Overlap Syndrome (BCOS) is a distinct clinical phenotype associated with greater symptom severity, more frequent chronic bronchial infection, and poorer prognosis than COPD alone. Case: This is a case of a 55-year-old male with a 20-year smoking history who presented with a COPD exacerbation characterized by worsening dyspnea, productive cough, tachypnea, and hypoxemia; chest radiograph showed pneumonia with emphysematous lung. Over two years of follow-up, serial chest radiographs demonstrated persistent pneumonia, progressive cystic bronchiectasis honey-comb like appearance, and emphysematous lung with additionally showing bilateral pulmonary artery dilation suggestive of pulmonary hypertension. Sputum culture isolated Staphylococcus aureus. Patient received sequential long-acting bronchodilator (LAMA/LABA) therapy, inhaled corticosteroids, and maintenance antibiotics, but still has not demonstrated a significant change in clinical response.