[Dysphagia] Re: Dysphagia Digest, Vol 21, Issue 1

[eripley at yahoo.com (Irene Campbell-Taylor)]

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Message: 2
Date: Mon, 1 Aug 2005 09:21:40 -0700 (PDT)
From: j ha 
Subject: [Dysphagia] bronch question


her history includes multiple pneumonias of unkown eti. chf and copd.

*** With both CHF and COPD, this woman is a high risk for pulmonary disease of all types including aspiration pneumonitis, not pneumonia because of the high incidence/prevalence of GERD in persons with COPD. It would be impossible to tell from an xray whether or not her pulmonary infiltrates are due to CHF, COPD or both, the reason that aspiration pneumonia cannot be diagnosed by xray alone.  the important issue above is that the "pneumonias" are of "unknown etiology" begging the question of whether or not they are actally pneumonias, pulmonary edema or chemical pneumonitis.

recently a mass was discovered in her lung 

*** With COPD her risk of pulmonary CA is very high and this could be causing the edema masquerading as pneumonia. Just because a patient may be aspirating from the oropharynx, it does not follow that pneumonia will result. this is a classic case of multiple other causes for pulmonary infiltrates.

 



Dr I Campbell-Taylor
Clinical Neuroscientist
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