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Aspiration pneumonia and bronchopneumonia in progressive supranuclear palsy treated with qing fei tang: two case reports.

Nozaki I, Kato-Motozaki Y, Ikeda T, Takahashi K, Tagami A, Ishida C, Komai K - J Med Case Rep (2015)

Bottom Line: Qing fei tang, which is used for various respiratory diseases, is useful for reducing relapse of aspiration pneumonia and bronchopneumonia in stroke, but the effect remains unknown in Parkinson's syndrome.Both of our patients clearly showed a reduced incidence of respiratory infection.Both of our patients clearly showed a reduced incidence of respiratory infection after the administration of qing fei tang.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1, Takara-machi, Kanazawa, 920-8640, Japan. ichi51@med.kanazawa-u.ac.jp.

ABSTRACT

Introduction: Qing fei tang, which is used for various respiratory diseases, is useful for reducing relapse of aspiration pneumonia and bronchopneumonia in stroke, but the effect remains unknown in Parkinson's syndrome. We report two cases of Japanese patients with progressive supranuclear palsy and relapsing aspiration pneumonia and bronchopneumonia, which was successfully prevented by qing fei tang.

Case presentation: Two Japanese men with progressive supranuclear palsy and receiving total enteral feeding (patient one (66-years-old) and patient two (76-years-old)) had experienced recurrent aspiration pneumonia and bronchopneumonia, which was unresponsive to conventional therapy. The respiratory infection developed twice at intervals of two months in patient one, and nine times at almost monthly intervals in patient two. Thereafter, they were given qing fei tang. After administration of qing fei tang, the respiratory infection reoccurred only once; after 5.5 months for patient one, and six months for patient two. Both of our patients clearly showed a reduced incidence of respiratory infection.

Conclusions: Both of our patients clearly showed a reduced incidence of respiratory infection after the administration of qing fei tang. Qing fei tang could be useful for the prevention of recurrent aspiration pneumonia and bronchopneumonia in progressive supranuclear palsy.

No MeSH data available.


Related in: MedlinePlus

The clinical course of patient one. The incidence of aspiration pneumonia and bronchopneumonia, which are shown by black triangles was exhibited before and after administration of qing fei tang at X month in patient one.
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Fig1: The clinical course of patient one. The incidence of aspiration pneumonia and bronchopneumonia, which are shown by black triangles was exhibited before and after administration of qing fei tang at X month in patient one.

Mentions: A 63-year-old Japanese man presented with speech difficulty, standing instability, drinking difficulty, and slow movement at first. At 12 months after his initial presentation, his neurological examination revealed cognitive decline, masked face, vertical oculomotor disturbance, dysarthria, bradykinesia, trunk-dominant muscular rigidity, and a tendency to fall. Magnetic resonance imaging of his head showed mild atrophy of the midbrain tegmentum. Probable PSP was diagnosed according to the National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) diagnostic criteria [2]. At 10 months after the diagnosis, he was confined to a wheelchair, and aspiration pneumonia occurred three times at monthly intervals. Although a percutaneous endoscopic gastrostomy (PEG) was performed immediately after his last pneumonia, pneumonia reoccurred twice at 18 and 20 months after his PEG regardless of treatment with clarithromycin and amantadine (Figure 1). A daily dose of 9g of qing fei tang (Tsumura & Co., Tokyo, Japan) was started, and aspiration pneumonia reoccurred only once, at 5.5 months after the start of treatment (Figure 1). The bacteria in his sputum were the same as before starting qing fei tang (Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA)), except for Streptococcus agalactiae.Figure 1


Aspiration pneumonia and bronchopneumonia in progressive supranuclear palsy treated with qing fei tang: two case reports.

Nozaki I, Kato-Motozaki Y, Ikeda T, Takahashi K, Tagami A, Ishida C, Komai K - J Med Case Rep (2015)

The clinical course of patient one. The incidence of aspiration pneumonia and bronchopneumonia, which are shown by black triangles was exhibited before and after administration of qing fei tang at X month in patient one.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403770&req=5

Fig1: The clinical course of patient one. The incidence of aspiration pneumonia and bronchopneumonia, which are shown by black triangles was exhibited before and after administration of qing fei tang at X month in patient one.
Mentions: A 63-year-old Japanese man presented with speech difficulty, standing instability, drinking difficulty, and slow movement at first. At 12 months after his initial presentation, his neurological examination revealed cognitive decline, masked face, vertical oculomotor disturbance, dysarthria, bradykinesia, trunk-dominant muscular rigidity, and a tendency to fall. Magnetic resonance imaging of his head showed mild atrophy of the midbrain tegmentum. Probable PSP was diagnosed according to the National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) diagnostic criteria [2]. At 10 months after the diagnosis, he was confined to a wheelchair, and aspiration pneumonia occurred three times at monthly intervals. Although a percutaneous endoscopic gastrostomy (PEG) was performed immediately after his last pneumonia, pneumonia reoccurred twice at 18 and 20 months after his PEG regardless of treatment with clarithromycin and amantadine (Figure 1). A daily dose of 9g of qing fei tang (Tsumura & Co., Tokyo, Japan) was started, and aspiration pneumonia reoccurred only once, at 5.5 months after the start of treatment (Figure 1). The bacteria in his sputum were the same as before starting qing fei tang (Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA)), except for Streptococcus agalactiae.Figure 1

Bottom Line: Qing fei tang, which is used for various respiratory diseases, is useful for reducing relapse of aspiration pneumonia and bronchopneumonia in stroke, but the effect remains unknown in Parkinson's syndrome.Both of our patients clearly showed a reduced incidence of respiratory infection.Both of our patients clearly showed a reduced incidence of respiratory infection after the administration of qing fei tang.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1, Takara-machi, Kanazawa, 920-8640, Japan. ichi51@med.kanazawa-u.ac.jp.

ABSTRACT

Introduction: Qing fei tang, which is used for various respiratory diseases, is useful for reducing relapse of aspiration pneumonia and bronchopneumonia in stroke, but the effect remains unknown in Parkinson's syndrome. We report two cases of Japanese patients with progressive supranuclear palsy and relapsing aspiration pneumonia and bronchopneumonia, which was successfully prevented by qing fei tang.

Case presentation: Two Japanese men with progressive supranuclear palsy and receiving total enteral feeding (patient one (66-years-old) and patient two (76-years-old)) had experienced recurrent aspiration pneumonia and bronchopneumonia, which was unresponsive to conventional therapy. The respiratory infection developed twice at intervals of two months in patient one, and nine times at almost monthly intervals in patient two. Thereafter, they were given qing fei tang. After administration of qing fei tang, the respiratory infection reoccurred only once; after 5.5 months for patient one, and six months for patient two. Both of our patients clearly showed a reduced incidence of respiratory infection.

Conclusions: Both of our patients clearly showed a reduced incidence of respiratory infection after the administration of qing fei tang. Qing fei tang could be useful for the prevention of recurrent aspiration pneumonia and bronchopneumonia in progressive supranuclear palsy.

No MeSH data available.


Related in: MedlinePlus