Rare clinical manifestation of community-acquired pneumonia

Abstract

A 71-year-old patient was admitted due to fever and persistent (>48 hours) hiccups. History and physical examination were not instructive. Lab tests were not specific, showing an inflammatory response. Chest film did not demonstrate opacities. The patient was treated with chlorpromazine with no relief. Fever and hiccups persisted, and therefore neck and chest CT was performed revealing a right lower lobe infiltrate, a finding consistent with pneumonia. Antibiotics were initiated and within 48 hours fever and hiccups resolved and patient recovered. Although hiccups are rarely described as a clinical manifestation of community acquired pneumonia, one should consider this diagnosis in a patient with unexplained fever.

Keywords: general practice/family medicine; pneumonia (infectious disease).

Figure 1

Patient upright posterior-anterior (upper) and lateral (lower) chest film on admission. Negative for pneumonia-related findings. The arrow is a technical symbol denoting the upright posture of the patient during chest x-ray.

Figure 2

Coronal (upper) and axial sections of a CT scan demonstrating opacity consistent with right lower lobe pneumonia.