A 78-Year-Old Female Presented with Chest Pain after Falling Down

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<p>本文描述一位78歲的女性患者，因跌倒導致右側肋骨骨折，三週後因疑似胸腔延遲性出血合併膿胸入院，住院後發現個案右膝化膿性關節炎合併膿瘍及菌血症，在接受胸腔鏡右側肋膜清創術及針對個案狀況更換多次抗生素治療後，全身性的感染終獲得控制順利出院。針對診斷為創傷性血胸合併膿胸之患者，入院後右膝疼痛常被視為創傷合併之症狀，亦有可能是引起個案跌倒與延遲性出血導致右側膿胸的主因。因此針對患者所陳述的各種主訴與徵候，皆應詳細詢問病史與理學檢查，再綜合檢驗檢查結果的判斷，方能及早作出正確的鑑別診斷與治療計劃，也才能及時給予患者正確的治療，從而降低死亡率及後續可能產生的各種併發症。</p> <p> </p><p>A 78-year-old female patient suffered from a right rib fracture due to a fall. Three weeks later, she was.admitted to the hospital with suspected delayed hemothorax and empyema. Through detailed medical history inquiry and evaluation based on subsequent CT scans and bacterial culture reports, it was con-firmed that she had septic arthritis of the right knee with an associated abscess and bacteremia. After undergoing thoracoscopic decortication of right pleura and multiple changes in antibiotic treatments tailored to her condition, the systemic infection was successfully controlled, and she was eventually discharged. In patients diagnosed with traumatic hemothorax complicated by empyema, the right knee pain upon admission is often considered a symptom of the trauma, but it could also be a signif-icant factor contributing to the patient’s fall and subsequent delayed bleeding leading to right-sided empyema. Therefore, it is essential to thoroughly inquire about the patient’s various complaints and symptoms, conduct a detailed medical history and physical examination, and then make a comprehen-sive judgment based on the results of laboratory and imaging tests to promptly establish an accurate differential diagnosis and treatment plan. This approach will enable timely and appropriate treatment for the patient, reducing the mortality rate and the potential occurrence of various complications.</p> <p> </p>