We thank V. Poletti and G.L. Casoni for their comments and interest in our case report 1.
Acute fibrinous and organising pneumonia is certainly a possible differential diagnosis in our patient. However, the patient's subacute presentation, dramatic response to steroids and clinical course were more in keeping with, and indeed typical of, cryptogenic organising pneumonia. In contrast, in the original series by Beasley et al. 2, of 17 patients with the histological diagnosis of acute fibrinous and organising pneumonia, nine patients had a fulminant course with rapid progression to death. Of the seven patients in this series who were treated with steroids (with or without antibiotics), only two survived. It should also be noted that the histological diagnosis of acute fibrinous and organising pneumonia was made from open lung and autopsy specimens in all cases.
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