The Eldest Female Case of Myasthenia Gravis with an Unusual Presentation: Aspiration Pneumonia as the Initial Manifestation

We report the eldest female case of myasthenia gravis (MG) that initially presented with aspiration pneumonia. A 91-year-old female with a high-grade fever and general malaise who had suffered from expectoration for several years was diagnosed with aspiration pneumonia. Thorough medical history taking and physical examination suggested the possibility of MG as a cause of aspiration pneumonia. Positive acetylcholine receptor antibody and waning phenomenon on a nerve conduction study confirmed the diagnosis. Treatment with intravenous immunoglobulin, prednisolone, and pyridostigmine resulted in a rapid improvement. Physicians should always consider the etiology of aspiration pneumonia to prevent further negative events.