Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Departamento de Medicina Interna, Monterrey, México.
Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Departamento de Cardiología, Monterrey, México.
Rev Inst Med Trop Sao Paulo. 2021 Jan 20;63:e3. doi: 10.1590/S1678-9946202163003. eCollection 2021.
Round pneumonia is an unusual radiological manifestation of a bacterial lung infection. We present the case of an elderly male patient who arrived at the emergency room with a productive cough and exertional dyspnea. His chest x-ray and CT showed a round opacity and air bronchograms in the right upper lobe. Taken together, the patient's symptoms and images strongly suggest a pulmonary infection. Empirical antibiotic therapy with ceftriaxone and clarithromycin was started. The sputum culture was positive for Enterobacter hormaechei and the bacterium was sensitive to levofloxacin; therefore, the antibiotic therapy was changed. Despite the treatment, the patient progressed to respiratory failure and septic shock, dying six days after admission. Although round pneumonia is uncommon, it is a potentially curable disease and clinicians should always consider it in their differential diagnosis.
球形肺炎是一种不常见的细菌性肺部感染的放射学表现。我们报告了一例老年男性患者，因咳嗽有痰和劳力性呼吸困难而到急诊就诊。他的胸部 X 线和 CT 显示右上叶有一个圆形不透明影和空气支气管征。综合患者的症状和影像学表现，强烈提示肺部感染。开始使用头孢曲松和克拉霉素进行经验性抗生素治疗。痰培养阳性为蜂房哈夫尼亚菌，该细菌对左氧氟沙星敏感；因此，抗生素治疗进行了更改。尽管进行了治疗，但患者仍进展为呼吸衰竭和感染性休克，入院后六天死亡。虽然球形肺炎并不常见，但它是一种可治愈的疾病，临床医生在鉴别诊断时应始终考虑到这一点。
