Diagnostic Dilemma: Investigating Respiratory Symptoms in a Middle-Aged Smoker

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL
Nazanin Zeinali Nezhad, Mitra Samareh Fekri, Amirhossein Shahpar, Mohsen Nakhaie, Mana Khazaeli, Mehrdad Farrokhnia, Faranak Salajegheh
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Abstract

This case report presents a diagnostic challenge encountered in a 65-year-old male admitted with fever, dyspnea, chest pain, and hemoptysis, alongside constitutional symptoms including weight loss, night sweats, and fatigue. Despite initial suspicion for pulmonary thromboembolism and empirical antibiotic therapy for pneumonia, subsequent bronchoscopic evaluation revealed acute necrotizing granulomatous bronchitis, strongly indicative of endobronchial tuberculosis (TB). This diagnosis emphasizes the importance of considering TB in patients with chronic respiratory symptoms, particularly in high-risk populations. Management involves initiating multidrug antitubercular therapy, close monitoring, infection control measures, and patient education. Prompt diagnosis and appropriate management are crucial in optimizing outcomes and reducing disease burden in TB.

Abstract Image

诊断难题:调查一名中年吸烟者的呼吸道症状
本病例报告介绍了一名 65 岁男性患者的诊断难题,患者因发热、呼吸困难、胸痛和咯血入院,同时伴有体重减轻、盗汗和乏力等全身症状。尽管最初怀疑是肺血栓栓塞症,并对肺炎进行了经验性抗生素治疗,但随后的支气管镜评估发现了急性坏死性肉芽肿性支气管炎,强烈提示支气管内结核(TB)。这一诊断强调了对有慢性呼吸道症状的患者,尤其是高危人群考虑肺结核的重要性。治疗包括启动多药抗结核治疗、密切监测、感染控制措施和患者教育。及时诊断和适当管理对于优化治疗效果和减轻结核病负担至关重要。
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来源期刊
Clinical Case Reports
Clinical Case Reports MEDICINE, GENERAL & INTERNAL-
自引率
14.30%
发文量
1268
审稿时长
13 weeks
期刊介绍: Clinical Case Reports is different from other case report journals. Our aim is to directly improve global health and increase clinical understanding using case reports to convey important best practice information. We welcome case reports from all areas of Medicine, Nursing, Dentistry, and Veterinary Science and may include: -Any clinical case or procedure which illustrates an important best practice teaching message -Any clinical case or procedure which illustrates the appropriate use of an important clinical guideline or systematic review. As well as: -The management of novel or very uncommon diseases -A common disease presenting in an uncommon way -An uncommon disease masquerading as something more common -Cases which expand understanding of disease pathogenesis -Cases where the teaching point is based on an error -Cases which allow us to re-think established medical lore -Unreported adverse effects of interventions (drug, procedural, or other).
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