Department of Pulmonary and Critical Care Medicine. University of Rochester Medicine Center. Rochester, NY.
Department of Pulmonary and Critical Care Medicine. University of Rochester Medicine Center. Rochester, NY.
Chest. 2024 Oct;166(4):e113-e116. doi: 10.1016/j.chest.2024.03.045.
A 63-year-old woman without significant medical history presented to an urgent care center with a 3-day history of fatigue and dyspnea on exertion. She was found to have an oxygen saturation in the low 80s on room air and was transferred to the closest hospital for further evaluation. Initial chest radiographs showed extensive bilateral interstitial opacities favoring the mid to lower lungs. A general infectious workup was unrevealing. The cause of her symptoms was thought to be an atypical bacterial or viral infection. She was discharged home on supplemental oxygen, 2 L/min via nasal cannula; instructed to finish a 7-day course of antibiotics; and given strict return precautions. Six days later she returned to the ED with worsening dyspnea despite finishing the prescribed course of antibiotics; she was admitted for further evaluation. She had emigrated from Northern India in the early 2000s. While in India, cooking was performed over an open fire. Their home was situated on a poultry farm. She has never smoked. She was up to date on typical cancer screening. She had no pets and denied further exposure to birds since moving to the United States. Her occupational history included manufacturing, but she denied significant exposure to dusts or metal shavings.
一位 63 岁的妇女，无明显病史，因疲劳和活动后呼吸困难 3 天到急诊中心就诊。她在室内空气中的血氧饱和度处于 80 年代的低值，并被转至最近的医院进行进一步评估。最初的胸部 X 光片显示广泛的双侧间质性混浊，偏向中下肺。一般感染性检查结果无明显异常。她的症状被认为是一种非典型的细菌或病毒感染。她出院时在家中接受补充氧气治疗，通过鼻导管吸氧 2 L/min；并被指示完成为期 7 天的抗生素疗程；并给予严格的复诊注意事项。六天后，她因呼吸困难加重再次回到急诊室，尽管已经完成了规定的抗生素疗程；她被收治入院进行进一步评估。她在 21 世纪初从印度北部移民过来。在印度时，做饭是在明火上进行的。他们的家位于一个家禽养殖场。她从不吸烟。她接受了常规的癌症筛查。她没有宠物，并且自搬到美国以来，没有进一步接触过鸟类。她的职业史包括制造业，但她否认有过大量接触粉尘或金属屑的情况。
