Brites Diana, Forra Catarina, Ferreira Mafalda, Sintra Sara, André Maria Eugénia
Internal Medicine, Unidade Local de Saúde de Castelo Branco, Castelo Branco, PRT.
Cureus. 2024 Oct 15;16(10):e71520. doi: 10.7759/cureus.71520. eCollection 2024 Oct.
This case report describes an elderly man with a history of alcohol use disorder and primary malignant liver neoplasm who presented to the emergency department with dyspnea, asthenia, fever, and signs of respiratory distress. Diagnostic tests, including a chest radiograph and computed tomography, revealed a large left-sided exudative pleural effusion with regular and diffuse pleural enhancement, a large tumor lesion in the left lobe with diaphragmatic and pleural invasion, and a liver with features suggestive of cirrhosis. Laboratory data showed increased inflammatory markers and hyperlactacidemia. Following thoracentesis, pleural fluid culture revealed the growth of . Despite targeted antibiotic therapy with the resolution of the infectious condition, the patient's clinical condition worsened, resulting in multiorgan failure, and the patient ultimately died in this context.
本病例报告描述了一名有酒精使用障碍病史和原发性恶性肝肿瘤的老年男性，他因呼吸困难、乏力、发热和呼吸窘迫体征就诊于急诊科。诊断性检查，包括胸部X光片和计算机断层扫描，显示左侧有大量渗出性胸腔积液，胸膜有规则且弥漫性强化，左叶有一个大的肿瘤病灶，侵犯了膈肌和胸膜，肝脏有提示肝硬化的特征。实验室数据显示炎症标志物升高和高乳酸血症。胸腔穿刺术后，胸水培养显示……生长。尽管采用了针对性抗生素治疗，感染状况得到缓解，但患者的临床状况仍恶化，导致多器官功能衰竭，患者最终在此情况下死亡。
