Round pneumonia is an unusual radiological manifestation of a bacterial lung infection. We present the case of an elderly male patient who arrived at the emergency room with a productive cough and exertional dyspnea. His chest x-ray and CT showed a round opacity and air bronchograms in the right upper lobe. Taken together, the patient’s symptoms and images strongly suggest a pulmonary infection. Empirical antibiotic therapy with ceftriaxone and clarithromycin was started. The sputum culture was positive for Enterobacter hormaechei and the bacterium was sensitive to levofloxacin; therefore, the antibiotic therapy was changed. Despite the treatment, the patient progressed to respiratory failure and septic shock, dying six days after admission. Although round pneumonia is uncommon, it is a potentially curable disease and clinicians should always consider it in their differential diagnosis.
Hiccups result from involuntary contractions of the diaphragm, driven by a complex neuromuscular reflex. Three patients with persistent hiccups underwent esophageal high-resolution manometry during hiccup episodes, revealing a consistent finding: sustained contraction of the esophagogastric junction with intermittent pressure peaks. This pattern, termed the “Hiccup-Induced Esophagogastric Waveform,” shows significant esophageal pressure changes linked to hiccup reflex. It may reflect a compensatory mechanism to expel excess esophageal residue or gas. These findings suggest hiccups could exacerbate symptoms of esophageal disorders, such as dysphagia and chest pain, and highlight the need for targeted therapeutic strategies. Further research is needed to explore these mechanisms.