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伪装成肺炎的主动脉夹层:一例非典型表现的病例报告

Aortic Dissection Masquerading as Pneumonia: A Case Report of an Atypical Presentation.

作者信息

Singh Gurjot, Trehan Shubam, Singh Didar, Goswami Kanishka, Arora Rajpreet S

机构信息

Internal Medicine, Saint John Hospital, Southern Illinois University, Springfield, USA.

Hospital Medicine, Springfield Clinic, Springfield, USA.

出版信息

Cureus. 2024 Aug 1;16(8):e65930. doi: 10.7759/cureus.65930. eCollection 2024 Aug.

Abstract

Aortic dissection is a critical and life-threatening condition that can present with atypical symptoms, often leading to misdiagnosis and delayed treatment. The report presents a case of a 65-year-old male who initially exhibited fever, right-sided chest pain, and a productive cough, resulting in an initial diagnosis of pneumonia. Despite empirical antibiotic therapy, his symptoms persisted, prompting further investigation. A computed tomography (CT) scan ultimately revealed a Type B aortic dissection. The patient was then transferred to a specialized tertiary care facility for successful endovascular intervention. This case underscores the importance of considering aortic dissection in patients presenting with persistent, atypical symptoms that do not respond to standard treatments, such as unexplained fever and chest pain. It highlights the crucial role of advanced imaging techniques, such as CT scans, in achieving an accurate and timely diagnosis. Clinicians must maintain a high index of suspicion and ensure prompt referral to specialized centers to improve patient outcomes in this potentially fatal condition.

摘要

主动脉夹层是一种危急且危及生命的疾病,可能表现为非典型症状,常常导致误诊和治疗延误。该报告呈现了一例65岁男性病例,其最初表现为发热、右侧胸痛和咳痰,初步诊断为肺炎。尽管进行了经验性抗生素治疗,但其症状持续存在,促使进一步检查。计算机断层扫描(CT)最终显示为B型主动脉夹层。随后该患者被转至一家专业的三级护理机构,成功接受了血管内介入治疗。该病例强调了对于出现持续、非典型症状且对标准治疗无反应(如不明原因发热和胸痛)的患者,考虑主动脉夹层的重要性。它凸显了先进成像技术(如CT扫描)在实现准确及时诊断方面的关键作用。临床医生必须保持高度的怀疑指数,并确保及时转诊至专业中心,以改善这种潜在致命疾病患者的治疗结果。

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