0
Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 62-Year-Old Woman With Chronic Cough and Bronchospasm

Jo-Chi Tseng, MD; Cheng-Cheng Hwang, MD; Wen-Bin Shieh, MD, FCCP
Author and Funding Information

Correspondence to: Jo-Chi Tseng, MD, Division of Pulmonary Medicine, Department of Internal Medicine and Department of Respiratory Therapy, Chang Gung Memorial Hospital, 222, Mai-Chin Road, Keelung 20418, Taiwan; e-mail: jochi77@adm.cgmh.org.tw


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(1):228-231. doi:10.1378/chest.09-0962
Text Size: A A A
Published online

Extract

A 62-year-old woman presented with chronic productive cough, intermittent wheezing, and shortness of breath over a 5-year period. She was a nonsmoker and had no history of environmental exposure to chemicals or dust. Her medical history was notable for nasopharyngeal cancer (NPC) treated with radiation therapy 26 years previously that resulted in mild dry mouth and hoarseness, nasal polyp, and chronic sinusitis. During the past 5 years, she underwent a series of examinations that revealed positive bronchodilator test and mild hyperinflation of lung parenchyma on chest radiograph. She received maintenance therapy with inhaled bronchodilator and corticosteroids, antihistaminics, and xanthine under the impression of chronic asthma and sinusitis, and antibiotics and oral corticosteroids during episodes of acute exacerbation. However, the clinical course fluctuated, with deterioration of symptoms on climatic changes or following upper respiratory tract infection. Even though the patient denied being aware of any episodes of aspiration, she was hospitalized and treated as having aspiration pneumonia on four occasions. Yet, no advanced study was performed to evaluate her swallowing function. Tracing back her history, she experienced occasional choking episodes while drinking, but did not pay attention to them. Over the past year, her symptoms of productive cough and dyspnea worsened, and pulmonary function tests revealed marked decreased FVC and FEV1.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

Suggested Readings

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543