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[Dysphagia] bronch question



Thank you, Irene, for those reminders. I received a referral today for a 
patient who was back from a hospital stay with exacerbation of his COPD, CHF 
with a concurrent pneumonia. This will be the second time I've evaluated him 
from his hospital admission and he does not exhibit any signs of primary 
aspiration with foods. I plan to send a note to his primary physician and 
the nurse practitioner reminding them of these issues.
JoAnn
----- Original Message ----- 
From: "Irene Campbell-Taylor" <eripley@yahoo.com>
To: <dysphagia@b9.com>
Sent: Monday, August 01, 2005 1:31 PM
Subject: [Dysphagia] Re: Dysphagia Digest, Vol 21, Issue 1


>
> ------------------------------
>
> 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
> Exclusive Distributor:
> www.interactivetherapy.com
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