Unresolving Pneumonia.
10.4046/trd.2004.57.6.604
- Author:
Do Seok BANG
1
;
In Sung JUNG
;
Ki Man KANG
;
Bum Chul PARK
;
Young Gul YOON
;
Jae Su KIM
;
Yol PARK
;
Sung Hoon LEE
;
Young Chul HONG
;
Kyoung Tae KO
;
Sang Min PARK
;
Dong Jib NA
Author Information
1. Department of Internal Medicine, Sun Hospital, DaeJeon, Korea. djna@sunhospital.com
- Publication Type:Case Report
- Keywords:
Pneumonitis;
Kerosene
- MeSH:
Anoxia;
Blood Gas Analysis;
Blood Pressure;
Bronchoscopy;
C-Reactive Protein;
Chest Pain;
Cough;
Diagnosis;
Dyspnea;
Emergency Service, Hospital;
Exudates and Transudates;
Fever;
Humans;
Kerosene;
Leukocytosis;
Lung;
Macrophages;
Percussion;
Pleural Effusion;
Pneumonia*;
Respiratory Rate;
Thorax;
Tomography, X-Ray Computed
- From:Tuberculosis and Respiratory Diseases
2004;57(6):604-608
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of 39degrees C, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still 39degrees C despite the aggressive therapy of community- acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.
