Lower lobe pneumonia presenting as singultus (hiccups)
Stamatis Karakonstantis1, Sofia Pitsigavdaki1, Dafni Korela1
11. 2 Department of Internal Medicine, General Hospital of Heraklion "Venizeleio-Pananeio", Leoforos Knossou, Heraklion, Greece.
Caspian Journal of Internal Medicine
|December 5, 2018
Summary
Persistent hiccups in elderly patients can signal pneumonia. This case highlights atypical pneumonia presentation, where hiccups were the primary symptom, resolving with antibiotics.
Area of Science:
- Internal Medicine
- Pulmonology
- Geriatrics
Background:
- Persistent hiccups are a debilitating symptom often leading patients to seek emergency care.
- Serious underlying conditions can cause persistent hiccups, though pneumonia is rarely described as a cause.
- Atypical presentations of common diseases are frequent in elderly patients.
Observation:
- A 79-year-old male presented with a 4-day history of persistent hiccups.
- Initial presentation lacked typical respiratory symptoms or fever.
- Diagnostic imaging revealed left lower lobe consolidation on chest X-ray and CT scan.
Findings:
- The patient was treated with levofloxacin for presumed pneumonia.
- Hiccups completely resolved after 1 month of treatment.
- Follow-up imaging confirmed resolution of the lung consolidation.
Implications:
- Pneumonia in the elderly can manifest atypically, without classic signs and symptoms.
- Persistent hiccups may be the sole presenting symptom of pneumonia in older adults.
- Early recognition and antibiotic treatment are crucial for resolving hiccup-related pneumonia.
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