2000 Volume 51 Issue 2 Pages 269-277
We report on two cases of relapsing aspiration pneumonia caused by dysphagia due to cerebrovascular disease. Sei-hai-to (Qing Fei tang) offered useful palliation in both cases. Case 1 was an 83-year-old-woman who was hospitalized for multiple lacunar infarction and lumbago in 1996. She gradually became bedridden within two years of the admission period. She was admitted to a long-term care hospital affiliated with our department in January 1998. Dysphagia and productive cough appeared in May, and enteral tube feeding was started after she developed pneumonia in August. Pneumonia persisted against some antibiotics, and feverish periods ranged from 8 to 18 days a month. CRP values were elevated to more than 5mg/dl. Administration of Sei-hai-to provided negative CRP values and decreased feverish periods to 0-2 days a month. Case 2 was a 93-year-old-man who suffered from cerebral bleeding in the right thalamus in 1984. He developed many attacks of aspiration pneumonia after starting oral feeding. He was admitted to a long-term care hospital affiliated with our department in April 1999. Sputum culture yielded P. aeruginosa and MRSA. Moreover, fluoroscopy showed aspiration into the lower airway. Aspiration pneumonia relapsed continually without antibiotics. Administration of both Sei-hai-to and clarithromycin decreased feverish periods and provided negative CRP values. Pneumonia relapsed easily either with Sei-hai-to therapy alone or Clarithromycin therapy alone.
