Lower lobe pneumonia presenting as singultus (hiccups)

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. 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. 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.