An autopsy case of acute fibrinous and organizing pneumonia with periorbital MRSA cellulitis and rheumatoid arthritis

This case report details a 78-year-old male with periorbital Methicillin-resistant Staphylococcus aureus (MRSA) cellulitis whose condition rapidly deteriorated despite treatment. An autopsy confirmed acute fibrinous and organizing pneumonia (AFOP), revealing fibrin ball formation and organizing pneumonia. While both idiopathic and secondary AFOP cases often exhibit bilateral consolidation on CT, our patient presented with ground-glass opacities, which are frequently associated with secondary AFOP. Notably, secondary AFOP, linked to higher mortality, can result from various factors. In this case, well-controlled rheumatoid arthritis and prolonged oral medication use suggest bilateral periorbital MRSA cellulitis as a significant factor. The study underscores AFOP's diagnostic challenges and the necessity for further research on effective treatments.