Department of Emergency Medicine, Cook County Health, 1950 W Polk Street, Chicago, IL 60612, USA.
Am J Emerg Med. 2020 Jul;38(7):1546.e5-1546.e6. doi: 10.1016/j.ajem.2020.04.045. Epub 2020 Apr 18.
Hiccups (singultus) are reflex inspiratory movements that involve the swallowing reflex arc and can be classified as acute (<48 h) or persistent (>48 h). A 62-year-old man with no history of malignancy or pulmonary disease presented to the Emergency Department with a four-day history of persistent hiccups. Other than episodic hiccupping, his physical examination was otherwise unremarkable. An abnormal chest X-ray led to a CT scan of the chest with IV contrast, which demonstrated regional, peripheral groundglass opacities of the upper lobes with small focal groundglass opacities scattered throughout the lungs. He was tested for COVID-19 per admission protocol, started on hydroxychloroquine, his hiccups improved, and he was discharged to home after 3 days. An emergency medicine physician should keep COVID-19 on the differential and be vigilant of exposure in atypical presentations.
呃逆（打嗝）是一种涉及吞咽反射弧的反射性吸气运动，可以分为急性（<48 小时）或持续性（>48 小时）。一名 62 岁男性，无恶性肿瘤或肺部疾病史，因持续性呃逆 4 天就诊于急诊科。除间歇性呃逆外，其体格检查无其他异常。异常的胸部 X 线片导致胸部 CT 扫描加静脉造影，显示上叶区域性、外周磨玻璃样混浊，肺部散布小灶性磨玻璃样混浊。根据入院方案，他接受了 COVID-19 检测，开始服用羟氯喹，呃逆改善，3 天后出院回家。急诊医生应将 COVID-19 列入鉴别诊断，并警惕在非典型表现中的接触。
