Background: In Japan, a “super-aged” society, the rate of end-stage dysphagia in the elderly is increasing. Artificial hydration and nutrition (AHN) can be used for such patients, although it may not improve mortality or quality of life. The many downsides of AHN are not always well explained to patients and their families, resulting in routine [...]

Case Presentation: Progressive dysphagia associated with weight loss is usually related to upper gastrointestinal cancer. As a differential diagnosis, fungal infections may present with a similar clinical presentation due to upper GI lesions. Paracoccidioidomycosis (PCM) infection is a systemic granulomatous disease caused by the fungi Paracoccidioides brasiliensis, especially important in rural areas of Latin America. [...]

Case Presentation: A 72-year-old man presented with several months of progressive weakness and dysphagia with a 70-pound weight loss. He was diagnosed with rheumatoid arthritis (RA) 4 months prior based on serology and synovial biopsy and was started on hydroxychloroquine. Previous work up for weight loss and dysphagia revealed a mild stricture versus delay in [...]

Case Presentation: A 71-year-old male presented to the emergency department (ED) complaining of a 3-week history of dysphagia and ~30lb weight loss. He had been transferred to the ED after a failed formal swallow evaluation, nearly three weeks after the onset of symptoms, during which he demonstrated significant aspiration even with thick liquids. In addition [...]