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Unusual cause of recurrent aspiration pneumonia
  1. Hiroki Matsuura1,2,
  2. Ryota Imamura3
  1. 1 Emergency Medicine, Okayama City Hospital, Okayama, Japan
  2. 2 General Internal Medicine, Okayama City Hospital, Okayama, Japan
  3. 3 Rheumatology, Okayama City Hospital, Okayama, Japan
  1. Correspondence to Dr Hiroki Matsuura, Emergency Medicine, Okayama City Hospital, Okayama 700-0962, Okayama, Japan; superonewex0506{at}yahoo.co.jp

https://doi.org/10.1136/emermed-2023-213243

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    Clinical introduction

    An 88-year-old man with intermittent fever, cough, vomiting and progressive dysphagia was transferred to our ED. His medical history was moderate hypertension and hyperlipidaemia. His family disclosed he had frequent repeated aspiration pneumonia within 3 months. A chest radiograph showed an obvious consolidation of the right lower lobe. Lateral radiograph of cervical spine was shown in figure 1.

    Figure 1

    Sagittal radiograph of cervical spine showed focal ossifications of the anterior longitudinal ligaments at C3/4 with posterior pharyngeal wall and the oesophagus pressed by the osteophytes.

    Question

    What is the most likely cause of recurrent aspiration pneumonia?

    1. Diffuse idiopathic skeletal hyperostosis

    2. Acute calcific retropharyngeal tendinitis

    3. Crowned dens syndrome

    4. Posterior longitudinal ligament …

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    Footnotes

    • Contributors HM contributed to writing the manuscript, discussion, diagnosis and patient care. RI contributed to discussion and patient care.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.