Abstract：
METHODS: An 82-year-old woman with a remote tracheostomy due to vocal cord paralysis and long-standing erosive, seropositive rheumatoid arthritis (RA) well controlled with methotrexate sought treatment at the ED with 1 month of dyspnea, chest tightness, and cough productive of blood-tinged sputum. She had been treated unsuccessfully as an outpatient with multiple courses of antibiotics. She did not smoke or drink alcohol and had no recent travel outside the country. Given concern for airway compromise, she was admitted to the hospital.
摘要：
方法：一名82岁女性，因声带麻痹和长期糜烂而进行远程气管造口术，血清阳性的类风湿性关节炎（RA）与甲氨蝶呤控制良好，在ED寻求治疗1个月的呼吸困难，胸闷,咳血痰。她作为门诊病人接受了多个疗程的抗生素治疗失败。她没有吸烟或饮酒，最近也没有出国旅行。考虑到气道受损，她被送进了医院。
