Hypersensitivity pneumonitis (HP) is a granulomatous interstitial disease that develops in genetically predisposed individuals as a result of an immune response to inhaled antigens. The case is presented of a 56-year-old male with HP with fibrosis, accompanied by severe respiratory failure (requiring HFNOT), significant oedema of the lower extremities, and a large amount of fluid in the right pleural cavity. The patient was initially in circulatory and respiratory failure, requiring infusion of catecholamines. During hospitalization thoracocentesis was performed, complicated by pneumothorax/lung expansion failure. Angio-CT revealed a pulmonary embolism. Targeted antibiotic therapy with voriconazole, meropenem and colistin, as well as bedside rehabilitation, resulted in the stabilization of the patient and improvement of his general condition. The patient was discharged home in a stable condition with the recommendation of home oxygen therapy.
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