Page 9 / April 07
The diagnosis now is abnormal communication between esophagus and superior segment bronchus of the right lower lobe and pneumonia presented with consolidation in the affected area. Aspiration pneumonia is the most likely complication and can explain the symptom of frequent coughing while eating that was misdiagnosed as "asthma" for years. Bronchoesophageal fistula can be congenital or acquired from tuberculosis. However, tuberculin skin test in this case being negative, tuberculosis is less likely. Bronchiectasis from repeated aspirations and infections is highly possible and can cause failure to thrive, clubbing of fingers and hemoptysis.
Pulmonary sequestration, pulmonary arterio-venous malformation, Allergic Bronchopulmonary Aspergillosis (ABPA), Wegener's granulomatosis, idiopathic pulmonary hemosiderosis can be ruled out from the obviously findings of CT scan chest.
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ANSWER:
The diagnosis now is abnormal communication between esophagus and superior segment bronchus of the right lower lobe and pneumonia presented with consolidation in the affected area. Aspiration pneumonia is the most likely complication and can explain the symptom of frequent coughing while eating that was misdiagnosed as "asthma" for years. Bronchoesophageal fistula can be congenital or acquired from tuberculosis. However, tuberculin skin test in this case being negative, tuberculosis is less likely. Bronchiectasis from repeated aspirations and infections is highly possible and can cause failure to thrive, clubbing of fingers and hemoptysis.
Pulmonary sequestration, pulmonary arterio-venous malformation, Allergic Bronchopulmonary Aspergillosis (ABPA), Wegener's granulomatosis, idiopathic pulmonary hemosiderosis can be ruled out from the obviously findings of CT scan chest.
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