• Indranil Chakravorty, William L G Oldfield, and Carlos M H Gómez.
• Department of Respiratory Medicine, Lister Hospital, Beds & Herts Postgraduate Medical School, Stevenage, UK. i.chakravorty@herts.ac.uk
• J Med Case Rep. 2008 May 6; 2: 145.

IntroductionBronchiolitis Obliterans Organising Pneumonia (BOOP) may often present initially as a recurrent spontaneous pneumothorax and then develop multi-system complications.Case PresentationA 17-year-old boy presented with a pneumothorax, which developed into rapidly progressive Bronchiolitis Obliterans Organising Pneumonia (BOOP). He developed multi-organ dysfunction (including adult respiratory distress syndrome, oliguric renal failure, acute coronary syndrome, cardiac failure and a right atrial thrombus) which necessitated prolonged intensive care. Diagnosis was confirmed on open lung biopsy and he responded well to treatment with corticosteroids.ConclusionBOOP is exquisitely sensitive to oral corticosteroids but if the diagnosis is not considered in such patients and appropriate treatment instituted early, BOOP may often lead to prolonged hospital admission with considerable morbidity.

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