Abstract
Two cases of aspiration pneumonia caused by methicillin resistant Staphylococcus aureus (MRSA) are reported.
Case 1, A 75-year-old male complained of dysphagia and misdeglutition caused by radiation myopathy. Fluoroscopy revealed lack of dilatation of the upper esophageal sphincter.
Case 2, A 81-year-old male suffered from sore throat and dysphagia after removal of a hypopharyngeal foreign body. Physical examinations revealed severe edema at the bilateral piriform sinuses.
Both cases had been intubated with a nasogastric (NG) tube and medicated β-lactam antibiotics prophylactically after the esophagoscopic examination under general anesthesia. On sixth and twelfth days after the examination, they developed aspiration pneumonia with complaints of chest pain and dyspnea, showing acute fever up, increase of white blood cell count and infiltrative shadow on chest X-p. MRSA was found from the sputa of both patients. FOM, CPZ and MINO were administered to case 1, FOM and CMZ to case 2. After medication, their conditions improved.
Our experiences of these cases suggest that NG intubation for dysphagia could be one of the causative factors of MRSA induced pneumonia.
