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個案報告:以下背痛為表現的肺炎非典型肺外症狀

Case Report: Low Back Pain as an Atypical Extrapulmonary Symptom of Pneumonia

摘要


本個案為52歲女性,過去無重大或慢性病史,因急性左側下背痛至門診就醫,初步診斷為泌尿道感染,接受抗生素治療後,尿液檢查報告有改善但急性下背痛仍未緩解。後至急診處理時,接受常規胸腔X光檢查意外發現左下肺野肋膜積液,後經電腦斷層檢查確診為左下肺肺炎。病人的下背痛在入院接受抗生素注射治療肺炎後的第4天即開始改善,至出院時已完全沒有下背痛的症狀。我們提出此個案,希望能讓臨床醫師了解急性下背痛可以是肺炎的非典型肺外症狀之一。

關鍵字

下背痛 肺炎 肺外症狀

並列摘要


A 52 year-old healthy woman visited our out-patient department for acute left low back pain. Urinary analysis led to an initial diagnosis of urinary tract infection, but antibiotic agent failed to alleviate her left low back pain. In the emergency department, left side pleural effusion was found accidentally by routine chest X-ray. Left lower lobe pneumonia with pleural effusion was confirmed by computed tomography later. Her left low back pain was improved after the treatment of levofloxacin. Acute low back pain may be an atypical extrapulmonary symptoms of pneumonia.

參考文獻


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Chou R, Qaseem A, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians: Diagnostic imaging for low back pain: advice for highvalue health care from the American College of Physicians. Ann Intern Med 2011; 154: 181-9.
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