An Unexpected Evolution: Severe Pneumonia in an Immunocompromised Patient.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2024-12-29 eCollection Date: 2024-12-01 DOI:10.7759/cureus.76572
Bernardo Silvério, Ana S Ramoa Oliveira, Ricardo Alves
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Abstract

Community-acquired pneumonia (CAP) varies in clinical presentation, ranging from mild pneumonia characterized by fever and productive cough to severe pneumonia characterized by respiratory distress and sepsis. We present a 40-year-old woman who presents to the emergency room with dyspnea, pleuritic chest pain, productive cough with hemoptysis, and fever. On physical examination, the patient presents with tachypnea and hypotension, which proved refractory to fluid therapy. The analysis reveals pancytopenia and elevated C-reactive protein. The computed tomography (CT) scan shows extensive areas of consolidation and ground-glass opacities, more prominent in the right upper lung lobe. The diagnosis of septic shock with a focus on CAP was established, and the patient was admitted to the Intensive Care Unit (ICU). Later, Streptococcus pyogenes was identified as the causative agent of this severe pneumonia.

意想不到的演变:免疫功能低下患者的严重肺炎。
社区获得性肺炎(CAP)的临床表现各不相同,从以发热和咳嗽为特征的轻度肺炎到以呼吸窘迫和败血症为特征的重度肺炎。我们报告一位40岁女性,因呼吸困难、胸膜炎性胸痛、咳咳伴咯血和发热而就诊于急诊室。体格检查时,患者出现呼吸急促和低血压,对补液治疗无效。分析显示全血细胞减少和c反应蛋白升高。计算机断层扫描(CT)显示广泛的实变区和磨玻璃影,在右肺上叶更为突出。脓毒性休克的诊断以CAP为重点,患者被送入重症监护病房(ICU)。后来,化脓性链球菌被确定为这种严重肺炎的病原体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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