Occlusive bronchiectasis mechanized pneumonia Occlusive bronchiectasis mechanized pneumonia (BOOP) is an inflammatory disease of the fine bronchi (bronchiectasis) and the tissues surrounding the lungs. BOOP is often caused by a pre-existing chronic inflammatory disease, such as rheumatoid arthritis. BOOP can also be a side effect of certain medications, such as amiodarone. BOOP was discovered in 1985 by Dr. Gary Epler? s . It is also known as cryptogenic (unknown etiology) mechanized pneumonia (COP) , and some primary sources suggest using the latter term (i.e., COP) to reduce confusion with occlusive bronchiectasis. Clinical features and imaging resemble infectious pneumonia. There is no response to treatment with multiple antibiotics, and blood and sputum cultures are negative, making the diagnosis of infectious pneumonia doubtful. The term “organic” refers to unresolved pneumonia (alveolar exudate remains and eventually undergoes fibrosis), with fibrous tissue forming in the alveoli. The period of inflammatory resolution and/or remodeling following bacterial infection is often referred to clinically and pathologically as pneumonia organosis. Signs and symptoms? Cough? Dyspnea? Influenza-like symptoms? Febrile illness? Widespread bursting sounds? Mild resting hypoxemia etiology may be triggered by COP/BOOP factors such as bacterial, viral infections and parasites, drugs or toxic odors (gases). Although its symptoms had previously been noted, it was not considered a separate lung disease and was not named until 1985. The risk of BOOP is higher in those with inflammatory diseases such as lupus, rheumatoid arthritis and scleroderma. On diagnostic clinical examination, popping sounds are common, and pestle fingers are less common in patients. Laboratory findings are nonspecific. Almost 75% are symptomatic, and patients have had symptoms for less than two months prior to seeking medical attention. Influenza A-like illness, cough, fever, feeling sick (malaise), fatigue, and weight loss are early warning signs of illness in about 40% of patients. Other than frequent popping sounds (rales), the physician did not find any specific routine laboratory or physical examination? abnormalities. Pulmonary function tests show that the amount of air that can be held in the lungs is lower than normal. The amount of oxygen in the blood tends to be low at rest and even lower during exercise. Imaging chest X-rays have features similar to those of common pneumonia, showing extensive white patches in both lungs. Due to the persistence and progression of the disease, the white patches appear to have metastasized regionally within the lungs and the diagnosis can be confirmed using computed tomography (CT ). CT is often typical enough for the physician to make a diagnosis without additional testing. To confirm the diagnosis, the doctor may perform a bronchoscopic lung biopsy. In many cases, a large number of specimens are needed and must be surgically removed. Plain radiographs show normal lung volumes with characteristic unilateral or bilateral consolidation of shifts. As many as 50% of patients have small nodular shadows and 15% of those with large nodules . On high-resolution computed tomography, alveolar infiltrates with air bronchial signs are present in more than 90% of patients, and in up to 50% of patients there is a lower regional predominance of subpleural or peribronchial distribution. Plaques combined with associated gross glassy and blurred shadows are seen in the majority of patients. The physiology of the lungs is limited by the reduced diffusing capacity of the lungs for carbon monoxide (DLCO). Airflow restriction is rare, usually with abnormal gas exchange, and mild hypoxemia is common. Fibrobronchoscopic bronchoalveolar lavage shows up to 40% lymphocytes, as well as an insignificant increase in neutrophils and eosinophils. In patients with typical clinical and imaging features, a trial diagnosis is made and treatment is initiated based on a bronchial biopsy showing the type of pathology of mechanized pneumonia and the lack of available diagnostic options. Surgical lung biopsy with a pathological-histological pattern of mechanized pneumonia with preserved lung tissue architecture; this pattern is not unique to BOOP and must be clinically interpreted …… treatment most patients recover with corticosteroid therapy. The standard approach of starting with a dose of 0.75 mg/kg and stopping over 24 weeks has been shown to reduce total glucocorticoid exposure without affecting outcomes. About two-thirds of patients recover with glucocorticoid therapy: typically steroid administration is done in Europe with hydrogenated prednisone and in the United States, with prednisone; these drugs differ by only one functional group and have the same clinical effect. Steroids are administered initially at high doses, typically 50 mg, and tapered to zero over a six-month to one-year period. If steroid therapy is stopped too quickly, the disease may recur. Steroid side effects must be counteracted with other drugs. The epidemiologically reported incidence is 0.01% and may be more common while undiagnosed. It usually begins between the ages of 40 and 60, in both sexes. Deaths are around 7% and tend to be in the elderly or those in poor health.