An Unexpected Cause of Postobstructive Pneumonia

A 72-year old man, who formerly used tobacco with a 60 pack-year history, was referred to our interventional pulmonology unit for evaluation of a severe stenosis of right main stem bronchus. This stenosis was discovered in a recent hospital admission for respiratory failure associated with right lower lobe pneumonia, which was considered postobstructive. After discharge, the patient continued to experience chest tightness and a persistent cough, which allowed him to expel mucus plugs only with considerable effort. He denied experiencing fever or weight loss. Three years earlier, in 2020, the patient had undergone a right upper lobectomy followed by adjuvant platinum-based chemotherapy for pT1cN1 squamous cell carcinoma. However, during the COVID-19 pandemic, he spontaneously declined any follow-up tests. His medical history was also significant for COPD, obesity, type II diabetes, myelodysplastic syndrome, aortic valve replacement for endocarditis, and rectal resection for pT3N0 adenocarcinoma.