Aspiration pneumonia triggered by the retention of an artificial tooth in the pharynx : a case report

Abstract

An 83-year-old-woman with dementia choked while having dinner, and visited our hospital with fever and dyspnea. The patient was diagnosed with aspiration pneumonia, and treated with antibiotics. Afterwards, the patient attempted oral intake but developed dysphagia resulting in the recurrence of aspiration pneumonia. We unsuccessfully attempted insertion of a nasogastric tube to introduce tube feeding. Subsequent endoscopic imaging showed the presence of an artificial tooth in the pyriform sinus ; the tooth was removed using a snare. The artificial tooth was confirmed by computed tomography (CT) on admission. In the event of accidental ingestion of an artificial tooth, CT is useful in addition to upper gastrointestinal endoscopy. Accidental ingestion of an artificial tooth should be considered when treating for aspiration pneumonia, particularly when patients with dementia repeat aspiration pneumonia.