Davis Boyd, Allauddin Tahir
Pulmonary and Critical Care, Southside Medical Center, Petersburg, USA.
Cureus. 2022 Jun 9;14(6):e25793. doi: 10.7759/cureus.25793. eCollection 2022 Jun.
Pneumonia is one of the most common pathologies seen in the inpatient setting. The rapid response to treat febrile patients with infiltrates on chest x-ray has reduced hospital length of stay and hospital costs. However, the automatic reaction to treat all infiltrates and opacities seen on a chest x-ray as pneumonia can be costly. This report presents the case of a patient suspected initially of having pneumonia, who was unresponsive to broad-spectrum antibiotics. A 58-year-old woman presented with dyspnea on exertion and a nonproductive cough. Her chest x-ray showed dense right-sided coalescent opacities encompassing the entirety of the right lung. Flexible bronchoscopy biopsy specimens revealed the cause to be cryptogenic organizing pneumonia. This case highlights the diverse set of pulmonary pathologies that can mimic pneumonia and should be suspected in cases of antibiotic-resistant suspected pneumonia patients.
肺炎是住院患者中最常见的病症之一。对胸部X线有浸润影的发热患者进行快速治疗,缩短了住院时间并降低了住院费用。然而,将胸部X线所见的所有浸润影和不透明区都自动当作肺炎来治疗可能代价高昂。本报告介绍了一名最初怀疑患有肺炎但对广谱抗生素无反应的患者的病例。一名58岁女性出现劳力性呼吸困难和干咳。她的胸部X线显示右侧致密融合性不透明影,累及整个右肺。经柔性支气管镜活检标本显示病因是隐源性机化性肺炎。该病例突出了一系列可模仿肺炎的肺部病症,对于疑似肺炎且对抗生素耐药的患者应怀疑这些病症。