Division of Infectious Diseases, Westchester Medical Center, Valhalla, NY.
Department of Neurology, Westchester Medical Center, Valhalla, NY.
Chest. 2023 Aug;164(2):e33-e37. doi: 10.1016/j.chest.2023.03.002.
A 53-year-old woman with no significant past medical history came to her local ED after a witnessed generalized tonic-clonic seizure. CT scan imaging of the head revealed a left frontal lobe hypodensity concerning for a mass with surrounding edema. In the previous month, she had undergone ambulatory evaluation for a subacute cough that had more recently become productive of bloody sputum. Outpatient chest radiography had demonstrated a new right lung opacity, shown on subsequent CT scan imaging to be a right upper lobe (RUL) consolidation. She was prescribed a course of doxycycline, after which sputum expectoration improved but a nonproductive cough remained. Repeat thoracic imaging was pending at the time the seizure occurred. The patient had no history of chronic lung disease or recurrent infections. There were no constitutional symptoms. She did not take any home medications on a regular basis. She was a lifetime nontobacco user. She denied use of alcohol and illicit drugs. She had previously worked in a medical office but was now spending most of her time helping her husband take care of their house and property in Kingston, New York, a town of about 23,000 people in the Hudson River Valley. She was born in the United States and had not traveled recently. She had no pets. There was no history of recent dental procedures. She was transferred to our institution for neurosurgical evaluation.
一位 53 岁的女性，既往无重大病史，因目击全身性强直阵挛性发作到当地急诊部就诊。头部 CT 扫描显示左额叶密度降低，考虑为肿块伴周围水肿。在过去的一个月里，她因亚急性咳嗽接受了门诊评估，最近咳嗽产生了血性痰。门诊胸部 X 线摄影显示右肺新出现不透明影，随后的 CT 扫描显示右上肺叶（RUL）实变。她被开了一个疗程的多西环素，之后痰量增加，但仍有干咳。在发生癫痫时，重复胸部成像仍在等待中。患者无慢性肺部疾病或反复感染史。无全身症状。她没有定期服用任何家庭药物。她是一个终身不吸烟的人。她否认使用酒精和非法药物。她以前在一家医疗办公室工作，但现在大部分时间都在帮助她的丈夫照顾他们在纽约州金斯敦的房子和财产，金斯敦是哈德逊河谷的一个约有 23000 人的城镇。她出生在美国，最近没有旅行。她没有宠物。最近没有牙科手术史。她被转介到我们的机构进行神经外科评估。
