Rahman Habib, Finnerty James, Somauroo John
NHS, Chester, UK.
BMJ Case Rep. 2013 Oct 7;2013:bcr2013009720. doi: 10.1136/bcr-2013-009720.
A previously completely fit and well 62-year-old man presented with a 4-week history of lethargy and increasing shortness of breath. This had been preceded by a flu-like illness that had been treated in the community with ciprofloxacin to no effect. There was no history of smoking, tuberculosis exposure or significant exposure to birds. Clinically the patient appeared well and was comfortable and conversant with no peripheral oedema. Chest auscultation revealed normal breath sounds and a loud pansystolic murmur over the cardiac apex. A chest radiograph and a subsequent CT scan showed widespread fibrotic and bronchiectatic changes, predominantly in the right upper lobe, with bilateral pleural effusions. Echocardiography revealed a posterior mitral valve prolapse. He was treated with loop diuretics and a mitral valve repair that resolved his symptoms and radiographic findings. This is the first English language case report of pulmonary oedema causing bronchiectatic lung appearances.
一名此前身体完全健康的62岁男性，出现了为期4周的乏力和进行性气短症状。在此之前，他患过一次类似流感的疾病，在社区接受环丙沙星治疗但无效。他无吸烟史、无结核接触史或无明显鸟类接触史。临床上，患者看起来状况良好，感觉舒适，能正常交流，无外周水肿。胸部听诊显示呼吸音正常，心尖部有响亮的全收缩期杂音。胸部X光片及随后的CT扫描显示广泛的纤维化和支气管扩张改变，主要位于右上叶，并伴有双侧胸腔积液。超声心动图显示二尖瓣后叶脱垂。他接受了袢利尿剂治疗及二尖瓣修复手术，症状和影像学表现均得到缓解。这是第一例关于肺水肿导致支气管扩张样肺部表现的英文病例报告。
