Silicosis is a preventable yet potentially fatal occupational lung disease caused by prolonged exposure to crystalline silica dust, leading to progressive lung fibrosis. This case report presents a 57-year-old male with silicosis complicated by progressive massive fibrosis (PMF) and associated with respiratory failure and other comorbidities, including pulmonary arterial hypertension, cor pulmonale, and a history of pulmonary tuberculosis (TB). The patient presented with shortness of breath, chest pain, fever, and a dry cough. Laboratory results revealed anemia, elevated white blood cells, and signs of respiratory acidosis. He was managed with antibiotics, corticosteroids, nebulized bronchodilators, and BiPAP therapy. Sputum culture isolated methicillin-resistant Staphylococcus aureus (MRSA), and antibiotic sensitivity testing showed resistance to several drugs. Silicosis, when complicated by PMF, results in severe respiratory impairment, and the patient's progression to type 1 respiratory failure worsened by pulmonary hypertension and cor pulmonale further deteriorated his prognosis. Silicosis increases susceptibility to infections like TB, and management focused on symptom control, infection prevention, and improving oxygenation. Antibiotic resistance highlighted the importance of targeted antimicrobial therapy in immunocompromised patients. This case underscores the severe consequences of silicosis, especially when complicated by PMF and coexisting conditions like pulmonary hypertension. Early diagnosis, prevention of silica exposure, and appropriate management are crucial to improving patient outcomes, with continued monitoring and infection control being essential in managing complex silicosis cases and preventing further deterioration.
Karunanithi et al. (Mon,) studied this question.