Persistent Hiccups Mystery: Individual Recently Experienced Prolonged Hiccups for Five Days, Possible Viral Cause Suspected
In Istanbul, a 60-year-old man sought help for a three-day bout of persistent hiccups. Upon examination at the hospital, his brain scans and other tests showed no irregularities. Yet, his lungs exhibited "obvious moist crackles," and a CT scan revealed nodules - indicative of viral pneumonia. A throat swab confirmed the man had contracted SARS-CoV-2, the culprit behind COVID-19.
Medical experts attributed his hiccups to his viral pneumonia. A report of the case drew parallels with studies from the early 2000s, suggesting that persistent hiccups might be associated with pneumonia. More recent studies hinted that prolonged and severe hiccups were linked to COVID-19.
The man was admitted to the hospital and received favipiravir, a medication for flu sometimes considered for treating COVID-19, and drugs to combat inflammation and bacterial infections. Antiviral treatments like Paxlovid were excluded, as they didn't factor into his care.
After two days, the hiccups persisted, so the medical team administered chlorpromazine, an antipsychotic known to quell muscle spasms. It's the only medication for hiccups authorized by the U.S. Food and Drug Administration. Following 12 hours and an additional two days, the man's hiccups ceased. He tested negative for COVID-19 after a decade of treatment, and his hiccups did not resurface during a subsequent follow-up visit.
Another case of hiccups coupled with COVID-19 pneumonia surfaced later, involving a 68-year-old man.
Why is this tale notable? Most hiccups stem from gastrointestinal issues, with the stomach influencing the diaphragm, which controls the hiccup reflex. Hiccups resulting from respiratory ailments are rare.
COVID-19 and pneumonia can indirectly cause persistent hiccups by igniting inflammation that affects the phrenic nerve, which regulates the diaphragm. Experts proposed that such instances may be more prevalent than previously suspected, as clinicians might not appreciate the connection between persistent hiccups and pneumonia or COVID-19.
Please remember that this content is meant for informational purposes only and should not be construed as medical advice.
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