Open AccessA case of laryngopharyngeal reflux‐associated chronic cough: Misinterpretation of treatment efficacy causes diagnostic delay
Author(s) -
Kikuchi Asuka,
Kawamoto Ryuichi,
Mizumoto Junki,
Akase Taichi,
Ninomiya Daisuke,
Kumagi Teru
Publication year - 2020
Publication title -
journal of general and family medicine
Language(s) - English
Resource type - Journals
ISSN - 2189-7948
DOI - 10.1002/jgf2.348
Subject(s) - medicine , laryngopharyngeal reflux , reflux , gram staining , laryngoscopy , rabeprazole , chronic cough , arytenoid cartilage , stain , sputum , proton pump inhibitor , surgery , laryngeal edema , intubation , edema , gastroenterology , disease , anesthesia , pathology , tuberculosis , staining , antibiotics , larynx , asthma , microbiology and biotechnology , biology
A 62‐year‐old woman presented with a dry cough lasting 18 months. She had previously been examined by multiple doctors, but no abnormalities were observed. Several medications such as rabeprazole and inhaled corticosteroids were administered as test treatments without any improvement. Therefore, the possibility of biological disease, including acid reflux, had been mistakenly ruled out. We examined the sputum gram stain. The result showed phagocyted normal bacterial flora, suggesting aspiration. Laryngoscopy revealed edema of the arytenoid cartilage. The patient was finally diagnosed with laryngopharyngeal reflux and silent aspiration. This case suggested that the ineffectiveness of proton‐pump inhibitors cannot always exclude the presence of reflux disease and the usefulness of gram stain examination to detect silent aspiration.