Qureshi Iman, Meshaka Riwa, Donohue Claire, Ali Asad
University Hospital Coventry and Warwickshire, Coventry, UK.
BMJ Case Rep. 2013 Jan 22;2013:bcr2012008197. doi: 10.1136/bcr-2012-008197.
A 32-year-old man presented overnight to the accident and emergency unit with mild breathlessness on exertion. He was found to be hypoxic on room air and his chest x-ray revealed areas of patchy lung consolidation. He was given intravenous antibiotics for presumed community-acquired pneumonia. Unfortunately his condition deteriorated and he remained significantly hypoxic despite high-flow oxygen with ECG evidence of right heart strain. Further questioning revealed a history of protein S deficiency and a strong family history of venous thromboembolic disease. An urgent CT pulmonary angiogram showed an evidence of massive pulmonary embolism and the patient was successfully thrombolysed.
一名32岁男性夜间因活动时轻度气促前往急诊室。在室内空气中发现他存在低氧血症，胸部X线显示肺部有斑片状实变区域。考虑为社区获得性肺炎，给予其静脉注射抗生素。不幸的是，他的病情恶化，尽管给予高流量氧气治疗，他仍严重缺氧，心电图显示有右心劳损迹象。进一步询问发现他有蛋白S缺乏病史，且有静脉血栓栓塞性疾病的家族史。紧急CT肺动脉造影显示有大面积肺栓塞的证据，该患者成功接受了溶栓治疗。
