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BMJ Case Rep：急性COPD恶化表现为明显的颅内出血和咯血——病例报告

2018-08-12 MedSci MedSci原创

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男性患者， 54岁，慢性阻塞性肺病（COPD）史，因出现亚急性胸痛，呼吸短促，咳嗽，咯血和盗汗而就诊。否认发烧或近期体重减轻。 胸部X线片显示右上叶大疱伴有相邻的浑浊和肺气肿。由于咯血和持续性胸痛的恶化，使用胸部增强CT检查，显示中度至重度肺气肿和许多充血的肺大疱。心脏检查未发现心肌缺血和主动脉夹层。分枝杆菌和侵袭性真菌感染的进一步传染性检查显示阴性。 最终患者接受了急性COPD急性加重治疗，对抗

男性患者， 54岁，慢性阻塞性肺病（COPD）史，因出现亚急性胸痛，呼吸短促，咳嗽，咯血和盗汗而就诊。否认发烧或近期体重减轻。

胸部X线片显示右上叶大疱伴有相邻的浑浊和肺气肿。由于咯血和持续性胸痛的恶化，使用胸部增强CT检查，显示中度至重度肺气肿和许多充血的肺大疱。心脏检查未发现心肌缺血和主动脉夹层。分枝杆菌和侵袭性真菌感染的进一步传染性检查显示阴性。

最终患者接受了急性COPD急性加重治疗，对抗生素反应良好，解决了咯血。胸部随访CT显示出血逐渐消退，患者无症状。

原始出处：

Runggaldier D, Minami T, et al., Acute COPD exacerbation presenting with pronounced intrabullous haemorrhage and haemoptysis. BMJ Case Rep. 2018 Jun 28;2018. pii: bcr-2018-225339. doi: 10.1136/bcr-2018-225339.

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    2019-01-21 gaoxiaoe

    #BMJ#

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    2018-10-17 charl1234567

    #case#

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    2018-08-20 xiaotao112411

    学习学习学习

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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:46 CST 2018, time=2018-08-16, status=1, ipAttribution=)]
    2018-08-20 xiaotao112411

    学习学习学习

    0

  5. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:46 CST 2018, time=2018-08-16, status=1, ipAttribution=)]
    2018-08-20 xiaotao112411

    学习学习学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1848577, encodeId=e13a18485e7c0, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Jan 21 22:09:00 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2027946, encodeId=711e202e9461e, content=<a href='/topic/show?id=7c9a41324e' target=_blank style='color:#2F92EE;'>#case#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4132, encryptionId=7c9a41324e, topicName=case)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62a7397, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:46 CST 2018, time=2018-08-16, status=1, ipAttribution=)]
    2018-08-20 xiaotao112411

    学习学习学习

    0

  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:46 CST 2018, time=2018-08-16, status=1, ipAttribution=)]
    2018-08-20 xiaotao112411

    学习学习学习

    0

  8. 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createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:31 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339630, encodeId=7bc133963006, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:28 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339629, encodeId=477533962923, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:25 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339628, encodeId=8451339628d0, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:22 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339627, encodeId=2b5533962e09, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:19 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338945, encodeId=0a743389459d, content= 学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:49 CST 2018, time=2018-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338944, encodeId=4e9133894426, content= 学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:46 CST 2018, time=2018-08-16, status=1, ipAttribution=)]
    2018-08-20 xiaotao112411

    学习学习学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1848577, encodeId=e13a18485e7c0, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Jan 21 22:09:00 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2027946, encodeId=711e202e9461e, content=<a href='/topic/show?id=7c9a41324e' target=_blank style='color:#2F92EE;'>#case#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4132, encryptionId=7c9a41324e, topicName=case)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62a7397, createdName=charl1234567, createdTime=Wed Oct 17 15:09:00 CST 2018, time=2018-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339633, encodeId=95c733963398, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:35 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339632, encodeId=fab23396321c, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:31 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339630, encodeId=7bc133963006, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:28 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339629, encodeId=477533962923, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:25 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339628, encodeId=8451339628d0, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:22 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339627, encodeId=2b5533962e09, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:19 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338945, encodeId=0a743389459d, content= 学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:49 CST 2018, time=2018-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338944, encodeId=4e9133894426, content= 学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:46 CST 2018, time=2018-08-16, status=1, ipAttribution=)]
    2018-08-16 xiaotao112411

    学习学习学习

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1848577, encodeId=e13a18485e7c0, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Mon Jan 21 22:09:00 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2027946, encodeId=711e202e9461e, content=<a href='/topic/show?id=7c9a41324e' target=_blank style='color:#2F92EE;'>#case#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4132, encryptionId=7c9a41324e, topicName=case)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62a7397, createdName=charl1234567, createdTime=Wed Oct 17 15:09:00 CST 2018, time=2018-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339633, encodeId=95c733963398, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:35 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339632, encodeId=fab23396321c, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:31 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339630, encodeId=7bc133963006, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:28 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339629, encodeId=477533962923, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:25 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339628, encodeId=8451339628d0, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:22 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339627, encodeId=2b5533962e09, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Mon Aug 20 00:22:19 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338945, encodeId=0a743389459d, content= 学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:49 CST 2018, time=2018-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338944, encodeId=4e9133894426, content= 学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Thu Aug 16 09:27:46 CST 2018, time=2018-08-16, status=1, ipAttribution=)]
    2018-08-16 xiaotao112411

    学习学习学习

    0

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