Lower lobe pneumonia presenting as singultus (hiccups)

BACKGROUND: Persistent hiccups can be a debilitating symptom and many such patients present to the emergency department seeking relief. A variety of serious conditions have been associated with persistent hiccups. Cases of pneumonia as a cause of hiccups have been rarely described. CASE PRESENTATION: A 79-year-old male patient presented to the hospital due to persistent hiccups for 4 days. Despite lack of new respiratory symptoms or fever, a chest x-ray demonstrated a left lower lobe consolidation, which was also confirmed with a chest CT. The patient was treated with levofloxacin and at 1-month follow-up hiccups had completely resolved, while a repeat chest CT demonstrated resolution of the consolidation. CONCLUSIONS: The presentation of pneumonia in elderly patients may be atypical and may lack the symptoms and signs observed in younger patients. Hiccups may be the main presenting symptom of pneumonia.