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抗结核治疗引起的严重血小板减少症表现为声带出血伴大量咯血导致死亡:一种灾难性的组合。

Anti-Tubercular-Therapy-Induced Severe Thrombocytopenia Presenting as a Vocal Cord Bleed With Massive Hemoptysis Causing Mortality: A Catastrophic Combination.

作者信息

Shaikh Suhail M, Toshniwal Saket, Wanjari Anil, Acharya Sourya, Kumar Sunil

机构信息

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Feb 7;16(2):e53752. doi: 10.7759/cureus.53752. eCollection 2024 Feb.

Abstract

Severe thrombocytopenia induced by anti-tubercular therapy (ATT) is a rare but potentially life-threatening complication. Severe thrombocytopenia is a known adverse effect of ATT, but its association with fatal hemoptysis is rare. Hematemesis and hemoptysis are two serious symptoms that indicate bleeding from the upper gastrointestinal and the lower respiratory tract, respectively. We report a rare case of a 65-year-old man, a diagnosed case of tuberculosis on ATT, who presented with massive hemoptysis. On navigating the bleed, the source was found to be a vocal cord bleed, which further led to massive clot formation in the left bronchus, leading to the collapse of the subsequent lung, leading to mortality. This case emphasizes the importance of recognizing ATT as a potential cause of bleeding and considering causes of massive hematemesis that are not gastrointestinal. It also highlights the need for a thorough evaluation of the airway in such patients.

摘要

抗结核治疗(ATT)引起的严重血小板减少是一种罕见但可能危及生命的并发症。严重血小板减少是ATT已知的不良反应,但其与致命咯血的关联罕见。呕血和咯血是分别提示上消化道和下呼吸道出血的两种严重症状。我们报告一例罕见病例,一名65岁男性,因ATT被诊断为结核病,出现大量咯血。在确定出血部位时,发现出血源是声带出血,这进一步导致左支气管内形成大量血凝块,进而导致随后的肺塌陷,最终导致死亡。该病例强调了认识到ATT作为出血潜在原因的重要性,并考虑非胃肠道原因导致的大量呕血。它还突出了对此类患者气道进行全面评估的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e6f/10927158/47454d2629ef/cureus-0016-00000053752-i01.jpg

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