George Washington University School of Medicine and Health Sciences, Washington, DC.
Department of Internal Medicine, The George Washington University, Washington, DC.
Chest. 2020 Oct;158(4):e163-e168. doi: 10.1016/j.chest.2020.05.545.
A 21-year-old man presented to the ED of The George Washington University Hospital complaining of chills, shortness of breath, hemoptysis, and a generalized rash. Three days before admission, he noticed a productive cough, severe sore throat, and subjective fever. He also experienced extreme fatigue, generalized sweating, and chest pain with coughing. On the day before admission, he experienced a nonpruritic rash on his neck, palms, and dorsal surfaces of his feet and sputum with streaks of blood. The patient had no significant medical or family history. He had no sick contacts, and his only recent travel was to an outdoor concert in a woody area of the northeastern United States about a month earlier. He did not report recent contact with birds or visits to caves. He is single, lives alone in an apartment, and consumes about 4 alcoholic beverages a week. Occasionally, he smokes cannabis and e-cigarettes. He is sexually active with men, and his last unprotected sexual encounter was a month earlier. He denied photophobia, rhinorrhea, ear pain, nasal congestion, abdominal pain, nausea, vomiting, diarrhea, or dysuria.
一位 21 岁男性因寒战、呼吸急促、咯血和全身皮疹到乔治华盛顿大学医院急诊科就诊。入院前 3 天，他出现咳嗽有痰、咽痛剧烈和自觉发热。他还感到极度疲劳、全身出汗和咳嗽时胸痛。入院前一天，他颈部、手掌和足背部出现无瘙痒的皮疹，咳痰带血丝。患者无重大医疗或家族病史。他没有生病的接触者，最近的旅行是大约一个月前到美国东北部一个多树木的地区参加户外音乐会。他没有报告最近接触过鸟类或去过洞穴。他独居在一间公寓里，每周大约喝 4 份含酒精的饮料。偶尔吸食大麻和电子烟。他与男性发生过无保护的性行为，最近一次无保护的性行为是在一个月前。他否认畏光、流涕、耳痛、鼻塞、腹痛、恶心、呕吐、腹泻或尿痛。
