Jackson Devon, Coke Lamarque, Fernandez Kamilah, Brister Kathriel
Howard University Hospital (HUH), Department of Pathology, Washington, DC, USA.
Howard University College of Medicine (HUCM), Washington, DC, USA.
Autops Case Rep. 2023 Aug 7;13:e2023443. doi: 10.4322/acr.2023.443. eCollection 2023.
pneumonia remains a difficult diagnosis and is most common in immunocompromised individuals. It has been rarely reported in immunocompetent individuals. We present a case of unsuspected pneumonia associated with esophagitis and gastritis discovered on postmortem examination in a presumably immunocompetent patient. The patient was a 71-year-old male who presented with chest pain and was subsequently found to have a myocardial infarction treated with angioplasty and drug-eluting stent placement. The patient's recovery was complicated by pneumonia refractory to antibiotics, and he went on to experience acute hypoxic respiratory failure, sepsis, disseminated intravascular coagulation (DIC), and ultimately expired. Autopsy revealed evidence of myocardial infarction as well as unsuspected pneumonia, esophagitis, and gastritis. Our case highlights how a presumably immunocompetent individual can develop this infection and how esophagitis and gastritis can be seen in association with pneumonia. Due to the difficulty in diagnosing pneumonia antemortem, autopsies provide a key opportunity to better understand these cases and the factors that may contribute to their development.
肺炎仍然是一种难以诊断的疾病，在免疫功能低下的个体中最为常见。在免疫功能正常的个体中很少有报道。我们报告一例在一名推测免疫功能正常的患者尸检时发现的与食管炎和胃炎相关的意外肺炎病例。该患者是一名71岁男性，因胸痛就诊，随后被发现患有心肌梗死，接受了血管成形术和药物洗脱支架置入治疗。患者的康复因对抗生素难治的肺炎而复杂化，他继而出现急性缺氧性呼吸衰竭、败血症、弥散性血管内凝血（DIC），最终死亡。尸检显示有心肌梗死以及意外的肺炎、食管炎和胃炎的证据。我们的病例突出了一名推测免疫功能正常的个体如何会发生这种感染，以及食管炎和胃炎如何会与肺炎相关出现。由于生前诊断肺炎存在困难，尸检为更好地理解这些病例以及可能导致其发生的因素提供了关键机会。
